5XX-32084-95366

5 vaccinations 12 coded responses 42 check-ins 11 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 040 / ME
Registered: 2021-03-18

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

2021-03-18
Registered in v-safe
2021-03-18
Dose 1 — Moderna
2021-03-18
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-20
Survey response — days 1–6 daily, dose 1
MedDRA: Oral herpes — Feeling: Good · Site: Pain

Free text: Cold sore

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: Oral herpes — Feeling: Good · Site: Pain

Free text: Cold sore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Oral herpes — Feeling: Good · Site: Pain

Free text: Cold sore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Oral herpes, Throat irritation — Feeling: Good · Headache

Free text: Cold sore, scratchy throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — days 1–6 daily, dose 1
MedDRA: Oral herpes — Feeling: Good · Headache

Free text: Cold sore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-01
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-15
Dose 2 — Moderna
2021-04-15
Survey response — day 0, dose 2
MedDRA: Injection site pain — Feeling: Good · Site: Pain

Free text: Burning at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Fast heartbeat staying between 90 and 100 BPM according to my Apple Watch. I noticed this last night after my last check in

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: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

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

Adult check-in
2021-04-29
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-27
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-15
Health check-in — 3 months, dose 2
Feeling: Good

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

Adult check-in
2021-11-04
Dose 3 — Moderna
2022-04-15
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-12
Dose 4 — Moderna
2022-05-13
Survey response — days 1–6 daily, dose 4
MedDRA: Heart rate increased — Feeling: Good · Site: Pain, Redness · Headache, Fatigue or tiredness, Diarrhea

Free text: My Heart is rate higher than usual according to my Apple Watch - it's about 90 And resting is normally under 70

MedDRA releases: 2024-11 · check-in free text available
2022-05-14
Survey response — days 1–6 daily, dose 4
MedDRA: Heart rate increased — Feeling: Good · Site: Pain, Redness · Fatigue or tiredness

Free text: Resting heart rate is still higher than normal for me, staying in the high 80's as opposed to 70 or below

MedDRA releases: 2024-11 · check-in free text available
2022-05-15
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness, Diarrhea

Adult check-in
2022-05-16
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-05-17
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-05-18
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-05-19
Health check-in — day 7, dose 4
Feeling: Good · Headache

Adult check-in
2022-05-26
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-02
Survey response — day 21, dose 4
MedDRA: Bronchitis — Feeling: Poor · 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: Bronchitis

MedDRA releases: 2024-11 · check-in free text available
2022-06-02
Report sent to call center — day 21, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-03
Call 1 — Left Voicemail
2022-06-03
Call successful
Not applicable - Accidental Reporting
2022-06-09
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-16
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-23
Survey response — day 42, dose 4
MedDRA: Asthma, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Asthma flare up

MedDRA releases: 2024-11 · check-in free text available
2022-06-23
Report sent to call center — day 42, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-24
Call 1 — Left Voicemail
2022-08-11
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-10
Dose 5 — Moderna
2022-11-10
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in
2023-05-14
Health check-in — 6 months, dose 5
Feeling: Fair

Adult check-in
2023-05-14
Survey response — 12 months, dose 4
MedDRA: Pneumonia — 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, Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-05-14
Report sent to call center — 12 months, dose 4
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 · 1 call case(s)
2023-05-15
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-05-15
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-18	Moderna
2	2021-04-15	Moderna
3	2021-11-04	Moderna	No
4	2022-05-12	Moderna	No
5	2022-11-10	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-20

Systemic reaction (other): Cold sore

2021-03-21

Systemic reaction (other): Cold sore

2021-03-22

Systemic reaction (other): Cold sore

2021-03-23

Systemic reaction (other): Cold sore, scratchy throat

2021-03-24

Systemic reaction (other): Cold sore

Release 7 — day 0, dose 2

2021-04-15

Systemic reaction (other): Burning at injection site

Release 7 — days 1–6 daily, dose 2

2021-04-17

Systemic reaction (other): Fast heartbeat staying between 90 and 100 BPM according to my Apple Watch. I noticed this last night after my last check in

Release 11 — days 1–6 daily, dose 4

2022-05-13

Systemic reaction (other): My Heart is rate higher than usual according to my Apple Watch - it's about 90 And resting is normally under 70

2022-05-14

Systemic reaction (other): Resting heart rate is still higher than normal for me, staying in the high 80's as opposed to 70 or below

Release 11 — day 21, dose 4

2022-06-02

Symptoms: Bronchitis

Release 12 — day 42, dose 4

2022-06-23

Symptoms: Asthma flare up

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	Asthma	·	·	✓
SD	Bronchitis	·	·	✓
SD	Pneumonia	·	·	✓
SD	Pre-existing disease	·	·	✓
SRO	Heart rate increased	·	·	✓
SRO	Injection site pain	✓	✓	✓
SRO	Oral herpes	✓	✓	✓
SRO	Throat irritation	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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