5UF-27267-55937

3 vaccinations 9 coded responses 36 check-ins 9 free-text entries 5 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 960 / CA
Registered: 2021-03-25

Relationship: Self
Race: Multiracial
Ethnicity: Not Hispanic or Latino

Registered dependents

PCR-48654-20574 Child or adolescent in my care · Male · 2021-10-21

PH4-39154-87476 Adult relative or friend · Male · 2021-10-21

KH3-42934-58228 Child or adolescent in my care · Male · 2021-11-16

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-25
Registered in v-safe
2021-03-25
Dose 1 — Moderna
2021-03-25
Survey response — day 0, dose 1
MedDRA: Dizziness, Feeling abnormal — Feeling: Fair · Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Really woozy, kind of dizzy and mentally fuzzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Joint pains, Nausea, Abdominal pain

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-04-01
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-04-08
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-22
Dose 2 — Moderna
2021-04-22
Health check-in — day 0, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Depression — Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Major depression

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Survey response — days 1–6 daily, dose 2
MedDRA: Chest pain — Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Chest pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Health check-in — day 7, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-05-06
Survey response — day 14, dose 2
MedDRA: Arthralgia, Pain, Pain in extremity — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Worsening joint pain .. Especially in my shoulder, wrists and hands/fingers

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-13
Survey response — day 21, dose 2
MedDRA: Dyspnoea, Feeling hot, Medical counselling, Palpitations — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Racing heart, short of breath, feeling very hot from within · Healthcare visit (other): Referred to a cardiologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-27
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-03
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-22
Health check-in — 3 months, dose 2
Feeling: Poor

Adult check-in
2021-10-21
Survey response — 6 months, dose 2
MedDRA: Glucose tolerance impaired, Pelvic pain, Smear cervix abnormal — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Moderate pain in pelvic region Abnormal pap (negative for any CA markers) Pre-diabetic (new .. family has no history of diabetes)

MedDRA releases: 2024-11 · check-in free text available
2021-10-21
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-22
Call 1 — Left Voicemail
2021-11-10
Dose 3 — Moderna
2021-11-14
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-11-15
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school

Adult check-in
2021-11-16
Survey response — days 1–6 daily, dose 3
MedDRA: Anger, Irritability — Feeling: Fair · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: I find that I'm a bit more irritated at things .. Short-tempered :(

MedDRA releases: 2024-11 · check-in free text available
2021-11-17
Health check-in — day 7, dose 3
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-24
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-01
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-08
Survey response — day 28, dose 3
MedDRA: Angina pectoris, Cardiac flutter, Chest pain — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Heart flutters and some chest pain. I have an appointment with a cardiologist tomorrow. These heart and chest pain started after my 1st dose.

MedDRA releases: 2024-11 · check-in free text available
2021-12-08
Report sent to call center — day 28, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-09
Call 2 — Left Voicemail
2021-12-15
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-22
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-02-09
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-05-11
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-10
Survey response — 12 months, dose 3
MedDRA: Depression, Pain in extremity, Suicidal ideation — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Severe depression and suicidal thoughts Leg pain and I don't have a reason as to why?

MedDRA releases: 2024-11 · check-in free text available
2022-11-10
Report sent to call center — 12 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-11-11
Call 1 — Left Voicemail
2022-11-11
Call 1 — Left Voicemail
2022-11-11
Call 2 — Left Voicemail
2022-11-11
Call 1 — Left Voicemail
2022-11-11
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-25	Moderna
2	2021-04-22	Moderna
3	2021-11-10	Moderna	No

Call center

5 call center cases

5 unsuccessful

2 waits over 3 months for a first call

See the call center timeline

Free text

Release 6 — day 0, dose 1

2021-03-25

Systemic reaction (other): Really woozy, kind of dizzy and mentally fuzzy

Release 8 — days 1–6 daily, dose 2

2021-04-27

Systemic reaction (other): Major depression

2021-04-28

Systemic reaction (other): Chest pain

Release 8 — day 14, dose 2

2021-05-06

Symptoms: Worsening joint pain .. Especially in my shoulder, wrists and hands/fingers

Release 8 — day 21, dose 2

2021-05-13

Symptoms: Racing heart, short of breath, feeling very hot from within

Healthcare visit (other): Referred to a cardiologist

Release 10 — 6 months, dose 2

2021-10-21

Symptoms: Moderate pain in pelvic region Abnormal pap (negative for any CA markers) Pre-diabetic (new .. family has no history of diabetes)

Release 10 — days 1–6 daily, dose 3

2021-11-16

Systemic reaction (other): I find that I'm a bit more irritated at things .. Short-tempered :(

Release 10 — day 28, dose 3

2021-12-08

Symptoms: Heart flutters and some chest pain. I have an appointment with a cardiologist tomorrow. These heart and chest pain started after my 1st dose.

Release 12 — 12 months, dose 3

2022-11-10

Symptoms: Severe depression and suicidal thoughts Leg pain and I don't have a reason as to why?

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".

MedDRA terms by release

Field	Preferred term	2021-09	2023-04	2024-11
HCVO	Medical counselling	✓	✓	✓
SD	Angina pectoris	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Cardiac flutter	·	·	✓
SD	Chest pain	·	·	✓
SD	Depression	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Feeling hot	✓	✓	✓
SD	Glucose tolerance impaired	·	·	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Palpitations	✓	✓	✓
SD	Pelvic pain	·	·	✓
SD	Smear cervix abnormal	·	·	✓
SD	Suicidal ideation	·	·	✓
SRO	Anger	·	·	✓
SRO	Chest pain	✓	✓	✓
SRO	Depression	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Irritability	·	·	✓

✓ active code · ○ coded but marked inactive · blank = not in that release