5ZS-16727-53869

4 vaccinations 10 coded responses 30 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 183 / PA
Registered: 2021-01-28

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

2021-01-21
Dose 1 — Moderna
2021-01-28
Registered in v-safe
2021-01-28
Survey response — day 7, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Pain · Muscle or body aches

Free text: I am late registering. On 1/21 and 1/22 I had pain at tge injection sites similar to a tetnus shot. It resolved on 1/23. No other sequelae

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — day 14, dose 1
MedDRA: Chills, Diarrhoea, Nausea — Feeling: Good

Free text: On Saturday, 1/30, which was 9 days post my fist Moderna vaccine, I had a 2 hour episode of chills and nausea with 2 loose stools

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-18
Dose 2 — Moderna
2021-02-25
Survey response — day 7, dose 2
MedDRA: Chills — Feeling: Good · Chills

Free text: Not today but I had to make a selection to write a comment here. On February 18th the day I got the vaccine I had chills beginning 3 hours after my vaccinations that lasted all day I did not have a fever. On Friday Saturday and Sunday I was fine but on Monday February 22nd I had the chills on and off again but I never had a fever.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-20
Survey response — 3 months, dose 2
MedDRA: Paraesthesia, Sleep disorder, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: I am experiencing tingling in my feet and toes at night. oftentimes this wakes me up from a sound sleep. i have never experienced this before. it started in late April. · Healthcare visit (other): I am contemplating making a visit if it continues. You dont have OTHER as a choice above so that is why I selected HCP

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-25
Survey response — 6 months, dose 2
MedDRA: Cervical spinal stenosis, Hypoaesthesia, Magnetic resonance imaging abnormal, Paraesthesia — Feeling: Good · Be unable to do your normal daily activities

Free text: Generalized numbness and tingling. Cervical MRI shows moderate stenosis at C4-5 and C5-6

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-26
Dose 3 — Moderna
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-10-30
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Good

Free text: On Thursday 10/28, I had a runny nose. On Friday, 10/29, I woke up with a sore throat that continued into the afternoon. I was concerned so I purchased a fast Covid test at CVS. This revealed a negative result. Today my throat is fine. No runny nose

MedDRA releases: 2024-11 · check-in free text available
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-02
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-11
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-18
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-25
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-30
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-07
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-27
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-09
Dose 4 — Moderna
2022-04-10
Survey response — days 1–6 daily, dose 4
MedDRA: Tachycardia — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Not today but yesterday approx 2 hours after I received my second booster. I had tech accordia for about 2 hours. It was actually concerning me. If it didn't stop I was going to go to the er. But it did go away

MedDRA releases: 2024-11 · check-in free text available
2022-04-11
Survey response — days 1–6 daily, dose 4
MedDRA: Fatigue — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: My fatigue is really bad.

MedDRA releases: 2024-11 · check-in free text available
2022-04-12
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-13
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-14
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-15
Survey response — days 1–6 daily, dose 4
MedDRA: Fatigue, Feeling abnormal — Feeling: Good

Free text: I think the CDC should contact the CVS Pharmacy in (b)(6) PA when I got my 2nd booster. Since I had such fatigue all week and it took me 6+ days to finally feel like myself, I am concerned that I may have gotten a full dose of Moderna not 1/2

MedDRA releases: 2024-11 · check-in free text available
2022-04-18
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-04-23
Survey response — day 14, dose 4
MedDRA: Adverse reaction — Feeling: Good

Free text: My response is actually NO but then I can't write a note. So I chose yes so I could. A week ago I asked you to contact the CVS (b)(6) PA to inquire as to what dosage I got for my booster My symptoms were so horrible for me for a week. Please do it!

MedDRA releases: 2024-11 · check-in free text available
2022-04-28
Call 1 — Left Voicemail
2022-04-28
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-21	Moderna
2	2021-02-18	Moderna
3	2021-10-26	Moderna	No
4	2022-04-09	Moderna	No

Call center

1 call center case

1 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 3 — day 7, dose 1

2021-01-28

Systemic reaction (other): I am late registering. On 1/21 and 1/22 I had pain at tge injection sites similar to a tetnus shot. It resolved on 1/23. No other sequelae

Release 3 — day 14, dose 1

2021-02-04

Symptoms: On Saturday, 1/30, which was 9 days post my fist Moderna vaccine, I had a 2 hour episode of chills and nausea with 2 loose stools

Release 4 — day 7, dose 2

2021-02-25

Systemic reaction (other): Not today but I had to make a selection to write a comment here. On February 18th the day I got the vaccine I had chills beginning 3 hours after my vaccinations that lasted all day I did not have a fever. On Friday Saturday and Sunday I was fine but on Monday February 22nd I had the chills on and off again but I never had a fever.

Release 8 — 3 months, dose 2

2021-05-20

Symptoms: I am experiencing tingling in my feet and toes at night. oftentimes this wakes me up from a sound sleep. i have never experienced this before. it started in late April.

Healthcare visit (other): I am contemplating making a visit if it continues. You dont have OTHER as a choice above so that is why I selected HCP

Release 9 — 6 months, dose 2

2021-08-25

Symptoms: Generalized numbness and tingling. Cervical MRI shows moderate stenosis at C4-5 and C5-6

Release 10 — days 1–6 daily, dose 3

2021-10-30

Systemic reaction (other): On Thursday 10/28, I had a runny nose. On Friday, 10/29, I woke up with a sore throat that continued into the afternoon. I was concerned so I purchased a fast Covid test at CVS. This revealed a negative result. Today my throat is fine. No runny nose cut off by CDC

Release 11 — days 1–6 daily, dose 4

2022-04-10

Systemic reaction (other): Not today but yesterday approx 2 hours after I received my second booster. I had tech accordia for about 2 hours. It was actually concerning me. If it didn't stop I was going to go to the er. But it did go away

2022-04-11

Systemic reaction (other): My fatigue is really bad.

2022-04-15

Systemic reaction (other): I think the CDC should contact the CVS Pharmacy in (b)(6) PA when I got my 2nd booster. Since I had such fatigue all week and it took me 6+ days to finally feel like myself, I am concerned that I may have gotten a full dose of Moderna not 1/2

redacted (b)(6)

Release 11 — day 14, dose 4

2022-04-23

Symptoms: My response is actually NO but then I can't write a note. So I chose yes so I could. A week ago I asked you to contact the CVS (b)(6) PA to inquire as to what dosage I got for my booster My symptoms were so horrible for me for a week. Please do it! cut off by CDC

redacted (b)(6)

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	Adverse reaction	·	·	✓
SD	Cervical spinal stenosis	✓	·	✓
SD	Chills	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Hypoaesthesia	✓	·	✓
SD	Magnetic resonance imaging abnormal	✓	·	✓
SD	Nausea	✓	✓	✓
SD	Paraesthesia	✓	✓	✓
SD	Sleep disorder	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Fatigue	·	·	✓
SRO	Feeling abnormal	·	·	✓
SRO	Injection site pain	✓	✓	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Rhinorrhoea	·	·	✓
SRO	SARS-CoV-2 test negative	·	·	✓
SRO	Tachycardia	·	·	✓

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