6AS-11580-98438

2 vaccinations 14 coded responses 25 check-ins 14 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 454 / OH
Registered: 2021-03-14

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

2021-03-13
Dose 1 — Moderna
2021-03-14
Registered in v-safe
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Chills, Somnolence, Tremor — Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Be unable to do your normal daily activities

Free text: very sleepy all the time and shaking with cold chills all the time

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — days 1–6 daily, dose 1
MedDRA: Heart rate increased, Illness — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Fatigue or tiredness, Abdominal pain

Free text: I had pounding fast heart rate.yesterday when I was really sick.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — days 1–6 daily, dose 1
MedDRA: Malaise — Feeling: Fair · Site: Pain, Swelling · Chills, Headache

Free text: How long do these symptoms last? Not wanting to get 2nd shot when this one made me sick.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling, Itching · Chills, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-20
Survey response — day 7, dose 1
MedDRA: Fatigue — Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Fatigue or tiredness, Abdominal pain

Free text: Fatigue!!!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — day 14, dose 1
MedDRA: Chills, Headache, Hot flush — Feeling: Fair · Be unable to do your normal daily activities

Free text: still have some cold chills off and on. Also have lots of hotflashes, also pain in head like electric shocks:( Not fun!!!.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — day 21, dose 1
MedDRA: Cough, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activities

Free text: I now have more caughing, more head congestion.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-04-17
Dose 2 — Moderna
2021-04-17
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-04-18
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: can't describe feeling.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness

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

Adult check-in
2021-04-21
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling hot, Hyperhidrosis — Feeling: Good · Site: Pain · Chills, Joint pains, Fatigue or tiredness, Abdominal pain

Free text: Hot and flushing sweats. throughout the day.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling hot, Hyperhidrosis — Feeling: Good · Site: Pain, Swelling, Itching · Chills, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: sweating and hot from inside out, uncomfortable

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-24
Survey response — day 7, dose 2
MedDRA: Flushing — Feeling: Fair · Site: Pain, Itching · Chills, Joint pains, Fatigue or tiredness, Abdominal pain

Free text: Flushing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-15
Health check-in — day 28, dose 2
Feeling: Poor

Adult check-in
2021-05-22
Survey response — day 35, dose 2
MedDRA: Abdominal pain upper, Diarrhoea, Medical counselling — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Stomach pains diarrhea · Healthcare visit (other): talked with Dr by phone

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-17
Survey response — 3 months, dose 2
MedDRA: Angina pectoris, Condition aggravated, Headache, Oropharyngeal pain, Pain, Pre-existing disease, Rhinorrhoea, Sneezing — Feeling: Fair · Be unable to work or attend school

Free text: sore throat, runny nose snezzing headache. aches in body. more arryrhmias, and heart pain.

MedDRA releases: 2024-11 · check-in free text available
2021-10-16
Survey response — 6 months, dose 2
MedDRA: Ageusia, Anosmia, Chillblains, Gout, Insomnia — 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: seepness, chills, gougt still no tast nor smell.

MedDRA releases: 2024-11 · check-in free text available
2021-10-16
Report sent to call center — 6 months, dose 2
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)
2021-10-19
Call 1 — Left Voicemail
2022-04-17
Survey response — 12 months, dose 2
MedDRA: Medical counselling, Trigeminal neuralgia — 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

Free text: Symptoms: I now have trigeminal neuralgia:( · Healthcare visit (other): dr on call

MedDRA releases: 2024-11 · check-in free text available
2022-04-17
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-04-22
Call 1 — Requested Callback
2022-04-22
Callback requested for
03:00PM ET
2022-04-22
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	2021-03-13	Moderna
2	2021-04-17	Moderna

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-14

Systemic reaction (other): very sleepy all the time and shaking with cold chills all the time

2021-03-15

Systemic reaction (other): I had pounding fast heart rate.yesterday when I was really sick.

2021-03-16

Systemic reaction (other): How long do these symptoms last? Not wanting to get 2nd shot when this one made me sick.

Release 6 — day 7, dose 1

2021-03-20

Systemic reaction (other): Fatigue!!!

Release 6 — day 14, dose 1

2021-03-27

Symptoms: still have some cold chills off and on. Also have lots of hotflashes, also pain in head like electric shocks:( Not fun!!!.

Release 6 — day 21, dose 1

2021-04-03

Symptoms: I now have more caughing, more head congestion.

Release 7 — days 1–6 daily, dose 2

2021-04-18

Systemic reaction (other): can't describe feeling.

2021-04-21

Systemic reaction (other): Hot and flushing sweats. throughout the day.

2021-04-22

Systemic reaction (other): sweating and hot from inside out, uncomfortable

Release 7 — day 7, dose 2

2021-04-24

Systemic reaction (other): Flushing

Release 8 — day 35, dose 2

2021-05-22

Symptoms: Stomach pains diarrhea

Healthcare visit (other): talked with Dr by phone

Release 9 — 3 months, dose 2

2021-07-17

Symptoms: sore throat, runny nose snezzing headache. aches in body. more arryrhmias, and heart pain.

Release 10 — 6 months, dose 2

2021-10-16

Symptoms: seepness, chills, gougt still no tast nor smell.

Release 11 — 12 months, dose 2

2022-04-17

Symptoms: I now have trigeminal neuralgia:(

Healthcare visit (other): dr on call

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	Medical counselling	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Ageusia	·	·	✓
SD	Angina pectoris	·	·	✓
SD	Anosmia	·	·	✓
SD	Chillblains	·	·	✓
SD	Chills	✓	✓	✓
SD	Condition aggravated	·	·	✓
SD	Cough	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Gout	·	·	✓
SD	Headache	✓	✓	✓
SD	Hot flush	✓	✓	✓
SD	Insomnia	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	Sneezing	·	·	✓
SD	Trigeminal neuralgia	·	·	✓
SRO	Chills	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Feeling hot	✓	✓	✓
SRO	Flushing	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Illness	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Somnolence	✓	✓	✓
SRO	Tremor	✓	✓	✓

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