67G-24912-21326

4 vaccinations 10 coded responses 39 check-ins 9 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 537 / WI
Registered: 2021-03-04

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

2021-03-04
Registered in v-safe
2021-03-04
Dose 1 — Moderna
2021-03-04
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good

Free text: Missed my check-in yesterday. Had mild soreness at injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-02
Dose 2 — Moderna
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-04-09
Survey response — day 7, dose 2
MedDRA: Abdominal pain — Feeling: Good · Abdominal pain

Free text: Not sure what you mean by abdominal pain, mine feels like possible bladder infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-02
Survey response — 3 months, dose 2
MedDRA: Bacterial infection, Cystitis, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Bladder infection, resistant bacteria · Healthcare visit (other): Labs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-02
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-07
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-10-01
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-04
Dose 3 — Moderna
2021-11-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-09
Survey response — days 1–6 daily, dose 3
MedDRA: Foot operation, Musculoskeletal stiffness, Pain — Feeling: Good · Be unable to do your normal daily activities

Free text: Podiatry surgery yesterday w/ pain, stiffness, antibiotic

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

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

Adult check-in
2021-11-18
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-25
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-02
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-09
Survey response — day 35, dose 3
MedDRA: Asthenia, Asthma, Diarrhoea, Pre-existing disease, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities

Free text: Asthma breathing problems related to cold, windy weather. Mild diarrhea, which has passed. I was low energy for two days. All but asthma symptoms are gone and I have tested negative for COVID.

MedDRA releases: 2024-11 · check-in free text available
2021-12-16
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-03
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-20
Dose 4 — Moderna
2022-05-05
Health check-in — 6 months, dose 3
Feeling: Good

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

Adult check-in
2022-05-11
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-18
Survey response — day 28, dose 4
MedDRA: Headache, Oropharyngeal pain, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headache, sore throat, runny nose.

MedDRA releases: 2024-11 · check-in free text available
2022-05-25
Survey response — day 35, dose 4
MedDRA: Lower respiratory tract infection, Medical counselling, SARS-CoV-2 test negative — 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

Free text: Bad chest cold, my Dr says it's going around. Double tested and COVID negative.

MedDRA releases: 2024-11 · check-in free text available
2022-05-25
Report sent to call center — day 35, 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 · 1 call case(s)
2022-05-26
Call 1 — Left Voicemail
2022-05-26
Call 1 — Left Voicemail
2022-05-31
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-01
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-20
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-19
Survey response — 6 months, dose 4
MedDRA: Candida infection, Nasopharyngitis, Pre-existing disease — Feeling: Good

Free text: A mild cold and a case of thrush due to an asthma medication.

MedDRA releases: 2024-11 · check-in free text available
2023-04-20
Survey response — 12 months, dose 4
MedDRA: Bursitis, Influenza like illness, Office visit, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-04-20
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 · 1 call case(s)
2023-04-21
Call successful
Not applicable - Accidental Reporting

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Moderna
2	2021-04-02	Moderna
3	2021-11-04	Moderna	No
4	2022-04-20	Moderna	No

Call center

3 call center cases

3 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-06

Systemic reaction (other): Missed my check-in yesterday. Had mild soreness at injection site.

2021-03-07

Systemic reaction (other): No

Release 7 — day 7, dose 2

2021-04-09

Systemic reaction (other): Not sure what you mean by abdominal pain, mine feels like possible bladder infection

Release 9 — 3 months, dose 2

2021-07-02

Symptoms: Bladder infection, resistant bacteria

Healthcare visit (other): Labs

Release 10 — days 1–6 daily, dose 3

2021-11-09

Systemic reaction (other): Podiatry surgery yesterday w/ pain, stiffness, antibiotic

Release 10 — day 35, dose 3

2021-12-09

Symptoms: Asthma breathing problems related to cold, windy weather. Mild diarrhea, which has passed. I was low energy for two days. All but asthma symptoms are gone and I have tested negative for COVID.

Release 11 — day 28, dose 4

2022-05-18

Symptoms: Headache, sore throat, runny nose.

Release 11 — day 35, dose 4

2022-05-25

Symptoms: Bad chest cold, my Dr says it's going around. Double tested and COVID negative.

Release 12 — 6 months, dose 4

2022-10-19

Symptoms: A mild cold and a case of thrush due to an asthma medication.

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	·	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Asthenia	·	·	✓
SD	Asthma	·	·	✓
SD	Bacterial infection	✓	✓	✓
SD	Bursitis	·	·	✓
SD	Candida infection	·	·	✓
SD	Cystitis	✓	✓	✓
SD	Diarrhoea	·	·	✓
SD	Headache	·	·	✓
SD	Influenza like illness	·	·	✓
SD	Lower respiratory tract infection	·	·	✓
SD	Medical counselling	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Foot operation	·	·	✓
SRO	Injection site pain	✓	✓	✓
SRO	Musculoskeletal stiffness	·	·	✓
SRO	No adverse event	✓	✓	✓
SRO	Pain	·	·	✓

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