5YX-11909-52958

3 vaccinations 9 coded responses 31 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 454 / OH
Registered: 2021-02-24

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

2021-02-24
Registered in v-safe
2021-02-24
Dose 1 — Moderna
2021-02-24
Survey response — day 0, dose 1
MedDRA: Emotional distress — Feeling: Good · Headache

Free text: was extra emotional which i also understand is a common accompanying condition

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Survey response — days 1–6 daily, dose 1
MedDRA: Disorientation — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: very odd feeling of mild disorientation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Survey response — days 1–6 daily, dose 1
MedDRA: Disorientation, Fatigue, Malaise, Pain, Toothache — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: i forgot to report that for the day following the vaccine my teeth hurt. Secondly i was feeling energetic and enthusiastic this morning then it was a rather sudden idd feeling almost as if disoriented.. the the pain elevated and was overcome with fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-03-03
Health check-in — day 7, dose 1
Feeling: Fair · Joint pains, Fatigue or tiredness

Adult check-in
2021-03-10
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-24
Survey response — day 28, dose 1
MedDRA: Abdominal discomfort, Arthralgia, Fatigue — Feeling: Fair

Free text: upset stomach .. joint pain and quite weary

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Dose 2 — Moderna
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-01
Survey response — day 7, dose 2
MedDRA: Dry skin, Erythema, Pruritus, Rash macular, Self-medication, Urticaria — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Fatigue or tiredness

Free text: After the vaccine within 12 hours I had bright red face splotches then one large one on back which ended up as hives. Benedryl helped them fade over the next few days.. those are dry and itchy now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — day 14, dose 2
MedDRA: Rash, Sinusitis — Feeling: Fair · Be unable to do your normal daily activities

Free text: rash and suspected sinus infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — day 21, dose 2
MedDRA: Cough, Sinusitis — Feeling: Fair · Be unable to do your normal daily activities

Free text: sinus infection.. perhaps strep throat.. coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-29
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-08
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-24
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-03-26
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-27
Dose 3 — Moderna
2022-04-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness · None

Adult check-in
2022-05-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness · None

Adult check-in
2022-05-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-05-04
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-05-11
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-05-18
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-05-25
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-06-01
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-06-08
Survey response — day 42, dose 3
MedDRA: Cough, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: cough, unny nose

MedDRA releases: 2024-11 · check-in free text available
2022-07-27
Survey response — 3 months, dose 3
MedDRA: Office visit, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: ssnhl in left ear · Healthcare visit (other): ent

MedDRA releases: 2024-11 · check-in free text available
2022-07-27
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-07-28
Call 1 — Left Voicemail
2023-04-29
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-24	Moderna
2	2021-03-25	Moderna
3	2022-04-27	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 4 — day 0, dose 1

2021-02-24

Systemic reaction (other): was extra emotional which i also understand is a common accompanying condition

Release 4 — days 1–6 daily, dose 1

2021-02-25

Systemic reaction (other): very odd feeling of mild disorientation

2021-02-26

Systemic reaction (other): i forgot to report that for the day following the vaccine my teeth hurt. Secondly i was feeling energetic and enthusiastic this morning then it was a rather sudden idd feeling almost as if disoriented.. the the pain elevated and was overcome with fatigue

Release 6 — day 28, dose 1

2021-03-24

Symptoms: upset stomach .. joint pain and quite weary

Release 6 — day 7, dose 2

2021-04-01

Systemic reaction (other): After the vaccine within 12 hours I had bright red face splotches then one large one on back which ended up as hives. Benedryl helped them fade over the next few days.. those are dry and itchy now.

Release 7 — day 14, dose 2

2021-04-10

Symptoms: rash and suspected sinus infection

Release 7 — day 21, dose 2

2021-04-15

Symptoms: sinus infection.. perhaps strep throat.. coughing

Release 11 — day 42, dose 3

2022-06-08

Symptoms: cough, unny nose

Release 12 — 3 months, dose 3

2022-07-27

Symptoms: ssnhl in left ear

Healthcare visit (other): ent

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	Abdominal discomfort	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	Sinusitis	✓	✓	✓
SD	Unevaluable event	·	·	✓
SRO	Disorientation	✓	✓	✓
SRO	Dry skin	✓	✓	✓
SRO	Emotional distress	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Rash macular	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Toothache	✓	✓	✓
SRO	Urticaria	✓	✓	✓

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