5XE-30256-22729

2 vaccinations 7 coded responses 26 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 850 / AZ
Registered: 2021-03-13

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

Timeline

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

2021-03-13
Registered in v-safe
2021-03-13
Dose 1 — Moderna
2021-03-13
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Fatigue or tiredness

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-20
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-27
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-03
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-10
Dose 2 — Moderna
2021-04-10
Survey response — day 0, dose 2
MedDRA: No adverse event — Feeling: Good

Free text: I just had my 2nd vaccine 5 minutes ago

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Kidney pain?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Fair · Fever · Headache, Fatigue or tiredness

Free text: Seem to now have a cough..not usual for me

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: Dizziness — Feeling: Fair · Site: Itching · Fever · Headache, Fatigue or tiredness

Free text: Dizzy

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

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Fatigue or tiredness

Adult check-in
2021-04-17
Health check-in — day 7, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-01
Survey response — day 21, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Really fatigued..

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Survey response — day 28, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Getting even more fatigued feeling..unlike anything I have felt before..

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-10
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-10
Survey response — 12 months, dose 2
MedDRA: Gastrointestinal inflammation, Head discomfort, Headache, Tinnitus, Vertigo — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Vertigo and tinnitus with headaches and pressure in head. Also inflation of the entire digestive system..all this after a shingles vaccine in August. But lasted for months, still have the headaches and pressure in head

MedDRA releases: 2024-11 · check-in free text available
2022-04-10
Report sent to call center — 12 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-11
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-13	Moderna
2	2021-04-10	Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 7 — day 0, dose 2

2021-04-10

Systemic reaction (other): I just had my 2nd vaccine 5 minutes ago

Release 7 — days 1–6 daily, dose 2

2021-04-11

Systemic reaction (other): Kidney pain?

2021-04-13

Systemic reaction (other): Seem to now have a cough..not usual for me

2021-04-14

Systemic reaction (other): Dizzy

Release 8 — day 21, dose 2

2021-05-01

Symptoms: Really fatigued..

Release 8 — day 28, dose 2

2021-05-08

Symptoms: Getting even more fatigued feeling..unlike anything I have felt before..

Release 11 — 12 months, dose 2

2022-04-10

Symptoms: Vertigo and tinnitus with headaches and pressure in head. Also inflation of the entire digestive system..all this after a shingles vaccine in August. But lasted for months, still have the headaches and pressure in head

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	Fatigue	✓	✓	✓
SD	Gastrointestinal inflammation	·	·	✓
SD	Head discomfort	·	·	✓
SD	Headache	·	·	✓
SD	Tinnitus	·	·	✓
SD	Vertigo	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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