5VL-28670-07443

2 vaccinations 8 coded responses 23 check-ins 8 free-text entries 0 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 497 / MI
Registered: 2021-03-16

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-03-16
Registered in v-safe
2021-03-16
Dose 1 — Moderna
2021-03-16
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-20
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Pre-existing disease, Respiratory tract congestion — Feeling: Fair · Fatigue or tiredness

Free text: A cough and congestion but I also have asthma

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Headache

Free text: Felt semi dizzy. Had similar episodes previous two days, almost like vertigo?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-30
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-06
Survey response — day 21, dose 1
MedDRA: Back pain, Chest discomfort, Chest pain, Middle insomnia — Feeling: Good

Free text: Awoke in the middle of the night with chest and mid back pressure/pain. Initially thought it was heartburn but had no acid reflux.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Dose 2 — Moderna
2021-04-13
Survey response — day 0, dose 2
MedDRA: Abdominal pain, Diverticulitis, Headache, Pre-existing disease — Feeling: Fair · Site: Pain · Headache, Abdominal pain

Free text: Mild headache and abdominal pain may be the result of a recent flare up of diverticulitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Lymph node pain, Lymphadenopathy, Pain, Pyrexia — Feeling: Poor · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Sore swollen throat glands. The fever and body aches actually started about 10 hours after my 8am shot and after Id already reported symptoms prior to them showing up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy, Oropharyngeal pain — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Sore Throat/Swollen glands

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Fair · Abdominal pain

Free text: Low back discomfort

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-22
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-18
Survey response — day 35, dose 2
MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: Fair

Free text: Sore throat and congestion with green mucus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-25
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-13
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-14
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-04-13
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-16	Moderna
2	2021-04-13	Moderna

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-20

Systemic reaction (other): A cough and congestion but I also have asthma

2021-03-21

Systemic reaction (other): Felt semi dizzy. Had similar episodes previous two days, almost like vertigo?

Release 7 — day 21, dose 1

2021-04-06

Symptoms: Awoke in the middle of the night with chest and mid back pressure/pain. Initially thought it was heartburn but had no acid reflux.

Release 7 — day 0, dose 2

2021-04-13

Systemic reaction (other): Mild headache and abdominal pain may be the result of a recent flare up of diverticulitis

Release 7 — days 1–6 daily, dose 2

2021-04-14

Systemic reaction (other): Sore swollen throat glands. The fever and body aches actually started about 10 hours after my 8am shot and after Id already reported symptoms prior to them showing up

2021-04-15

Systemic reaction (other): Sore Throat/Swollen glands

2021-04-17

Systemic reaction (other): Low back discomfort

Release 8 — day 35, dose 2

2021-05-18

Symptoms: Sore throat and congestion with green mucus

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
SD	Back pain	✓	✓	✓
SD	Chest discomfort	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Middle insomnia	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Diverticulitis	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓

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