65V-41204-51916

4 vaccinations 11 coded responses 35 check-ins 11 free-text entries 6 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 870 / NM
Registered: 2021-01-30

Relationship: Self
Race: American Indian or Alaska Native
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-01-30
Registered in v-safe
2021-01-30
Dose 1 — Moderna
2021-01-30
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Itching · Fever · None

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

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-02-06
Health check-in — day 7, dose 1
Feeling: Fair · Fever · Headache, Muscle or body aches, Abdominal pain

Adult check-in
2021-02-14
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-20
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-27
Dose 2 — Moderna
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Breast pain, Injection site pain, Injection site warmth — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Breast on shot side very sore. Shot are very hot and sore.

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

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Joint pains, Fatigue or tiredness

Adult check-in
2021-03-06
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-13
Health check-in — day 14, dose 2
Feeling: Good

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

Adult check-in
2021-03-27
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-03
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-10
Survey response — day 42, dose 2
MedDRA: Abdominal pain, Headache, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headache and sore throat and abdominal pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-31
Survey response — 3 months, dose 2
MedDRA: Abdominal wall haemorrhage, Anaemia, Gastric haemorrhage — 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, Hospitalization

Free text: Abdominal bleed, severe anemia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-31
Report sent to call center — 3 months, 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)
2021-08-28
Survey response — 6 months, dose 2
MedDRA: Chills, Fatigue, Headache, Influenza like illness, Office visit, Pain, Pyrexia — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Fatigue and flu like symptoms, fever, chills, headache, body aches. · Healthcare visit (other): PCP

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-28
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-31
Call X — Left Voicemail
2021-09-24
Dose 3 — Moderna
Co-administered: Tetanus
2021-10-26
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-10-31
Survey response — day 35, dose 3
MedDRA: Chills, Fatigue, Headache, Pain, Pyrexia, Rhinorrhoea, Sneezing — Feeling: Poor · Be unable to work or attend school

Free text: Fatigue, headache, fever, chills, body aches, sneezing, runny nose

MedDRA releases: 2024-11 · check-in free text available
2021-11-07
Survey response — day 42, dose 3
MedDRA: Influenza like illness — Feeling: Fair · Be unable to work or attend school

Free text: Flu like

MedDRA releases: 2024-11 · check-in free text available
2021-12-24
Survey response — 3 months, dose 3
MedDRA: Migraine — Feeling: Fair · Be unable to do your normal daily activities

Free text: Migraine headaches

MedDRA releases: 2024-11 · check-in free text available
2022-03-27
Survey response — 6 months, dose 3
MedDRA: Wheezing — 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 · Telehealth, virtual health, or email health consultation

Free text: Wheezing

MedDRA releases: 2024-11 · check-in free text available
2022-03-27
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-03-28
Call 1 — Left Voicemail
2022-04-25
Dose 4 — Moderna
2022-05-08
Health check-in — day 7, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-05-09
Survey response — day 14, dose 4
MedDRA: Arthralgia, Pain, Pain in extremity — 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 · Outpatient clinic or urgent care clinic visit

Free text: Arm where shot was given is very painful throughout shoulder and clavicle.

MedDRA releases: 2024-11 · check-in free text available
2022-05-09
Report sent to call center — day 14, 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-10
Call 1 — Left Voicemail
2022-05-10
Call 1 — Left Voicemail
2022-05-10
Call 2 — Left Voicemail
2022-05-10
Call 1 — Left Voicemail
2022-05-10
Callback requested for
03:30PM ET
2022-05-16
Survey response — day 21, dose 4
MedDRA: Pain in extremity, Peripheral swelling — Feeling: Poor · Be unable to work or attend school, 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: Injection arm more swollen and painful

MedDRA releases: 2024-11 · check-in free text available
2022-05-16
Report sent to call center — day 21, 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-17
Call 2 — Could Not Reach Participant
2022-05-17
Call 2 — Could Not Reach Participant
2022-05-17
Call 3 — Could Not Reach Participant
2022-05-17
Call 2 — Could Not Reach Participant
2022-05-17
Call 1 — Could Not Reach Participant
2022-05-20
Call 3 — Left Voicemail
2022-05-20
Call 3 — Left Voicemail
2022-05-20
Call X — Left Voicemail
2022-05-20
Call 3 — Left Voicemail
2022-05-20
Call 2 — Left Voicemail
2022-05-23
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-05-30
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-06-06
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-07-25
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-10-24
Survey response — 6 months, dose 4
MedDRA: Cold sweat, Cough, Decreased appetite, Diarrhoea, Fatigue, Influenza like illness, Lethargy, Migraine, Pain, Sneezing — 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 · Outpatient clinic or urgent care clinic visit

Free text: Explosive and daily diarrhea. Lethargy. Extreme fatigue. Migraine headaches. Decline in appetite. On and off flu like symptoms to include body sureness, sneezing, coughing, clamminess, etc.

MedDRA releases: 2024-11 · check-in free text available
2022-10-24
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-25
Call 3 — Left Voicemail
2022-10-25
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-30	Moderna
2	2021-02-27	Moderna
3	2021-09-24	Moderna	Tetanus
4	2022-04-25	Moderna	No

Call center

6 call center cases

6 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-03-02

Systemic reaction (other): Breast on shot side very sore. Shot are very hot and sore.

Release 7 — day 42, dose 2

2021-04-10

Symptoms: Headache and sore throat and abdominal pain

Release 8 — 3 months, dose 2

2021-05-31

Symptoms: Abdominal bleed, severe anemia

Release 9 — 6 months, dose 2

2021-08-28

Symptoms: Fatigue and flu like symptoms, fever, chills, headache, body aches.

Healthcare visit (other): PCP

Release 10 — day 35, dose 3

2021-10-31

Symptoms: Fatigue, headache, fever, chills, body aches, sneezing, runny nose

Release 10 — day 42, dose 3

2021-11-07

Symptoms: Flu like

Release 10 — 3 months, dose 3

2021-12-24

Symptoms: Migraine headaches

Release 11 — 6 months, dose 3

2022-03-27

Symptoms: Wheezing

Release 11 — day 14, dose 4

2022-05-09

Symptoms: Arm where shot was given is very painful throughout shoulder and clavicle.

Release 11 — day 21, dose 4

2022-05-16

Symptoms: Injection arm more swollen and painful

Release 12 — 6 months, dose 4

2022-10-24

Symptoms: Explosive and daily diarrhea. Lethargy. Extreme fatigue. Migraine headaches. Decline in appetite. On and off flu like symptoms to include body sureness, sneezing, coughing, clamminess, etc.

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 pain	✓	✓	✓
SD	Abdominal wall haemorrhage	✓	·	✓
SD	Anaemia	✓	✓	✓
SD	Arthralgia	·	·	✓
SD	Chills	✓	·	✓
SD	Cold sweat	·	·	✓
SD	Cough	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	✓	·	✓
SD	Gastric haemorrhage	○	✓	○
SD	Headache	✓	✓	✓
SD	Influenza like illness	✓	·	✓
SD	Lethargy	·	·	✓
SD	Migraine	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	·	✓
SD	Pain in extremity	·	·	✓
SD	Peripheral swelling	·	·	✓
SD	Pyrexia	✓	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sneezing	·	·	✓
SD	Wheezing	·	·	✓
SRO	Breast pain	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site warmth	✓	✓	✓

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