5XS-29693-17615

4 vaccinations 8 coded responses 45 check-ins 7 free-text entries 6 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 300 / GA
Registered: 2021-03-31

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-03-30
Dose 1 — Moderna
2021-03-31
Registered in v-safe
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · None

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-15
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-27
Dose 2 — Moderna
2021-04-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activities

Adult check-in
2021-04-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activities

Adult check-in
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-05-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-05-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-04
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-19
Survey response — day 21, dose 2
MedDRA: Cellulitis — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Developed an acute case of abdominal wall cellulitis..

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Report sent to call center — day 21, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-25
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-06-01
Survey response — day 35, dose 2
MedDRA: Blood potassium increased, Dehydration, Fatigue — Feeling: Poor · Be unable to work, 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: Still dehydrated, fatigued, potassium levels highly elevated.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Report sent to call center — day 35, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-08
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-20
Dose 3 — Moderna
2021-10-21
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-22
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Fatigue or tiredness

Adult check-in
2021-10-23
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Joint pains, Fatigue or tiredness

Adult check-in
2021-10-27
Survey response — day 7, dose 3
MedDRA: Erythema, Injection site swelling, Pain, Syringe issue, Underdose, Wrong technique in product usage process — Feeling: Good · Site: Pain, Redness, Swelling, Itching

Free text: I run through these questions that i failed to mention, my boostershot was most likely done incorrectly. The rx tech, bunched my skin, i don't even feel that she hit subdermal area. Hence the leakage, the area swelling, redness, pain.

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-10
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-17
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-24
Survey response — day 35, dose 3
MedDRA: Oropharyngeal pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Extremely sore throat.

MedDRA releases: 2024-11 · check-in free text available
2021-12-01
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-19
Survey response — 3 months, dose 3
MedDRA: Dyspnoea, Office visit, Palpitations — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Heart palpitations and shortness of breath. · Healthcare visit (other): Cardiologist visit

MedDRA releases: 2024-11 · check-in free text available
2022-01-19
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-20
Call 1 — Left Voicemail
2022-04-20
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-08-12
Dose 4 — Moderna
Co-administered: Flu
2022-08-14
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Fatigue or tiredness

Adult check-in
2022-08-15
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-08-17
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-08-18
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-08-19
Health check-in — day 7, dose 4
Feeling: Good · Site: Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-08-26
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-09-02
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-09-09
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-09-16
Survey response — day 35, dose 4
MedDRA: Brain fog, Fatigue — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Fatigue and mental fog

MedDRA releases: 2024-11 · check-in free text available
2022-09-16
Report sent to call center — day 35, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-09-19
Call 2 — Could Not Reach Participant
2022-09-19
Call 2 — Could Not Reach Participant
2022-09-19
Call 3 — Could Not Reach Participant
2022-09-19
Call 2 — Could Not Reach Participant
2022-09-22
Call 3 — Could Not Reach Participant
2022-09-22
Call 3 — Could Not Reach Participant
2022-09-22
Call 3 — Could Not Reach Participant
2022-11-13
Survey response — 3 months, dose 4
MedDRA: Flank pain, Renal pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Flank- kidney pain.

MedDRA releases: 2024-11 · check-in free text available
2022-11-13
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-11-14
Call X — Left Voicemail
2022-11-14
Call X — Left Voicemail
2022-11-14
Call X — Left Voicemail
2022-11-14
Call X — Left Voicemail
2022-11-14
Call 2 — Left Voicemail
2023-02-10
Survey response — 6 months, dose 4
MedDRA: Cardiac failure — 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 · Emergency room or emergency department visit, Hospitalization

MedDRA releases: 2024-11
2023-02-10
Report sent to call center — 6 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2023-02-13
Call 1 — Left Voicemail
2023-02-13
Call 1 — Left Voicemail
2023-02-13
Call 2 — Left Voicemail
2023-02-13
Call 1 — Left Voicemail
2023-02-13
Call 1 — Left Voicemail
2023-02-13
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-30	Moderna
2	2021-04-27	Moderna
3	2021-10-20	Moderna	No
4	2022-08-12	Moderna	Flu

Call center

6 call center cases

6 unsuccessful

2 waits over 3 months for a first call

See the call center timeline

Free text

Release 8 — day 21, dose 2

2021-05-19

Symptoms: Developed an acute case of abdominal wall cellulitis..

Release 8 — day 35, dose 2

2021-06-01

Symptoms: Still dehydrated, fatigued, potassium levels highly elevated.

Release 10 — day 7, dose 3

2021-10-27

Systemic reaction (other): I run through these questions that i failed to mention, my boostershot was most likely done incorrectly. The rx tech, bunched my skin, i don't even feel that she hit subdermal area. Hence the leakage, the area swelling, redness, pain.

Release 10 — day 35, dose 3

2021-11-24

Symptoms: Extremely sore throat.

Release 10 — 3 months, dose 3

2022-01-19

Symptoms: Heart palpitations and shortness of breath.

Healthcare visit (other): Cardiologist visit

Release 12 — day 35, dose 4

2022-09-16

Symptoms: Fatigue and mental fog

Release 12 — 3 months, dose 4

2022-11-13

Symptoms: Flank- kidney pain.

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	Office visit	·	·	✓
SD	Blood potassium increased	✓	✓	✓
SD	Brain fog	·	·	✓
SD	Cardiac failure	·	·	✓
SD	Cellulitis	✓	✓	✓
SD	Dehydration	✓	✓	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Flank pain	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Palpitations	·	·	✓
SD	Renal pain	·	·	✓
SRO	Erythema	·	·	✓
SRO	Injection site swelling	·	·	✓
SRO	Pain	·	·	✓
SRO	Syringe issue	·	·	✓
SRO	Underdose	·	·	✓
SRO	Wrong technique in product usage process	·	·	✓

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