5XL-15069-94760

2 vaccinations 7 coded responses 15 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 46-50
ZIP prefix: 234 / VA
Registered: 2021-04-22

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

2021-03-24
Dose 1 — Moderna
2021-04-21
Dose 2 — Moderna
2021-04-22
Registered in v-safe
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

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

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Headache, Muscle or body aches

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-28
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-05
Survey response — day 14, dose 2
MedDRA: Alopecia — Feeling: Good

Free text: Hair loss

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Survey response — day 21, dose 2
MedDRA: Alopecia — Feeling: Good

Free text: Significantly increased hair loss

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Survey response — day 28, dose 2
MedDRA: Alopecia, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Severely tired, hair loss

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Survey response — day 35, dose 2
MedDRA: Alopecia, Fatigue, Lethargy, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Significant lethargy, exhaustion, and hair loss. The vaccine seems to have triggered flare ups of two viruses I have previously had debilitating issues with, as well. I believe my immune system just may not strong enough to handle it all well.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Survey response — day 42, dose 2
MedDRA: Cough, Fatigue, Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activities

Free text: Cough, feeling of fluid in lungs (worsening long-haul COVID symptoms bc I had COVID last spring & haven't fully recovered); hair loss; fatigue. 2nd shot taxed my immunity; EBV must have reactivated & is causing a chronic fatigue flare up for me.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-21
Survey response — 3 months, dose 2
MedDRA: Condition aggravated, Pathogen resistance, Pre-existing disease, Urinary tract infection — Feeling: Poor · Be unable to work or attend school

Free text: recurring antibiotic-resistant UTI, worsening of respiratory issues due to Long-COVID

MedDRA releases: 2024-11 · check-in free text available
2021-10-20
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-24
Survey response — 12 months, dose 2
MedDRA: Arthralgia, Neuralgia, Sciatica, Unevaluable event — 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

Free text: Symptoms: Lots of joint and nerve pain and neuralgia--especially back, neck, and sciatic pain. It's been almost constant since the booster shot i received. · Healthcare visit (other): Lab work, referrals to specialists

MedDRA releases: 2024-11 · check-in free text available
2022-04-24
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

1 call case(s)
2022-04-25
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-24	Moderna
2	2021-04-21	Moderna

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 8 — day 14, dose 2

2021-05-05

Symptoms: Hair loss

Release 8 — day 21, dose 2

2021-05-12

Symptoms: Significantly increased hair loss

Release 8 — day 28, dose 2

2021-05-19

Symptoms: Severely tired, hair loss

Release 8 — day 35, dose 2

2021-05-26

Symptoms: Significant lethargy, exhaustion, and hair loss. The vaccine seems to have triggered flare ups of two viruses I have previously had debilitating issues with, as well. I believe my immune system just may not strong enough to handle it all well.

Release 8 — day 42, dose 2

2021-06-02

Symptoms: Cough, feeling of fluid in lungs (worsening long-haul COVID symptoms bc I had COVID last spring & haven't fully recovered); hair loss; fatigue. 2nd shot taxed my immunity; EBV must have reactivated & is causing a chronic fatigue flare up for me.

Release 9 — 3 months, dose 2

2021-07-21

Symptoms: recurring antibiotic-resistant UTI, worsening of respiratory issues due to Long-COVID

Release 11 — 12 months, dose 2

2022-04-24

Symptoms: Lots of joint and nerve pain and neuralgia--especially back, neck, and sciatic pain. It's been almost constant since the booster shot i received.

Healthcare visit (other): Lab work, referrals to specialists

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	Unevaluable event	·	·	✓
SD	Alopecia	✓	✓	✓
SD	Arthralgia	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Cough	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Lethargy	✓	✓	✓
SD	Neuralgia	·	·	✓
SD	Pathogen resistance	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Sciatica	·	·	✓
SD	Urinary tract infection	·	·	✓

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