6B3-22193-14233

2 vaccinations 9 coded responses 20 check-ins 9 free-text entries 4 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 900 / CA
Registered: 2021-04-14

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-04-13
Dose 1 — Moderna
2021-04-14
Registered in v-safe
2021-04-14
Survey response — days 1–6 daily, dose 1
MedDRA: Somnolence — Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I watched a movie last night. I was up kinda late, and I had a long day yesterday. With little sleep. I took a nap. Now I feel much better. So it was probably because being up late watching movies.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-22
Survey response — day 7, dose 1
MedDRA: Myalgia — Feeling: Good · Muscle or body aches

Free text: Minor minor muscle ache...

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-05-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-11
Dose 2 — Moderna
2021-05-11
Survey response — day 0, dose 2
MedDRA: Dizziness, Immediate post-injection reaction, Nausea, Office visit — Feeling: Fair · Site: Pain · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): I had to stay a little longer after my 2nd injection. I felt a moment of nausea..then that went to light headed minor dizzy. Wheelchairs came..long story short.. I will go to my Dr for a update. Dumdum forgotten to take my blood pressure pill and I didn't eat. · Healthcare visit (other): Inside this location. The wonderful Dr and staff really went out of there way to assist me. I left happy no spinning or light headed or dizziness. I took it slowly and carefully. Chilling now until tomorrow to get updated from my Dr...from THE Clinic... Nurse Practitioner, (b)(6)...I forgot the Dr I always see her.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Report sent to call center — day 0, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-12
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: I have an appointment tomorrow to update blood pressure. I am taking the blood pressure pills I have. But I will have an update tomorrow. Or by the next v-safe check in. No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction, Dizziness, Memory impairment, Office visit — Feeling: Good · Site: Pain · Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): Very very mild · Healthcare visit (other): I went to my Dr and got an update on my blood pressure. It was better. Two digits at the bottom three at the top. I am to monitor it for next few weeks. And I go back.. maybe to update Rx... we'll see. But maybe that now it not related to the vaccine shot. But the Dr office where I received the injection made me stay longer due to my blood pressure. I felt light headed, kindi dizzy. But I think I forgotten to take my blood pressure pill day of 2nd injection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-17
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Self-medication — Feeling: Fair · Headache

Free text: As soon as I awakened this morning a headache came where I took two tylenols you shall take nothing... I was not at where my blood pressure pill was.,..

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-25
Survey response — day 14, dose 2
MedDRA: Hypertension — Feeling: Fair

Free text: My BP is still riding high.I'm logging the numbers for my next blood pressure check.It may have always been higher than usual.But Im presently aware &taking my blood pressure pills. 3 times a day.1on empty stomach and 2 full..

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-22
Survey response — day 42, dose 2
MedDRA: Blood pressure increased, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: My blood pressure was right on.. perfect. I went today and got the update.When I got the 2nd shot my blood pressure went up up up... · Healthcare visit (other): THE Clinic

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-22
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-24
Call 2 — Could Not Reach Participant
2021-06-28
Callback requested for
02:00PM ET
2021-06-29
Call 3 — Could Not Reach Participant
2021-08-10
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-05-11
Survey response — 12 months, dose 2
MedDRA: Cystitis, Pharyngitis streptococcal — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: I had a bladder infection... followed by strep throat... But all better now... With some antibiotics..The throat thing was interesting... But Dr Office said everything was negative... So all better...

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-05-12
Call 1 — Requested Callback
2022-05-12
Call 1 — Requested Callback
2022-05-12
Call 1 — Requested Callback
2022-05-12
Call 1 — Requested Callback
2022-05-26
Callback requested for
03:00PM ET
2022-05-27
Call successful
Does not wish to fill out VAERS report
2022-05-27
Call successful
Does not wish to fill out VAERS report
2022-05-27
Call successful
Does not wish to fill out VAERS report
2022-05-27
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-13	Moderna
2	2021-05-11	Moderna

Call center

4 call center cases

4 successful

2 waits over 3 months for a first call

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-14

Systemic reaction (other): I watched a movie last night. I was up kinda late, and I had a long day yesterday. With little sleep. I took a nap. Now I feel much better. So it was probably because being up late watching movies.

Release 7 — day 7, dose 1

2021-04-22

Systemic reaction (other): Minor minor muscle ache...

Release 8 — day 0, dose 2

2021-05-11

Systemic reaction (other): I had to stay a little longer after my 2nd injection. I felt a moment of nausea..then that went to light headed minor dizzy. Wheelchairs came..long story short.. I will go to my Dr for a update. Dumdum forgotten to take my blood pressure pill and I didn't eat.

Healthcare visit (other): Inside this location. The wonderful Dr and staff really went out of there way to assist me. I left happy no spinning or light headed or dizziness. I took it slowly and carefully. Chilling now until tomorrow to get updated from my Dr...from THE Clinic... Nurse Practitioner, (b)(6)...I forgot the Dr I always see her.

redacted (b)(6)

Release 8 — days 1–6 daily, dose 2

2021-05-12

Systemic reaction (other): I have an appointment tomorrow to update blood pressure. I am taking the blood pressure pills I have. But I will have an update tomorrow. Or by the next v-safe check in. No

2021-05-14

Systemic reaction (other): Very very mild

Healthcare visit (other): I went to my Dr and got an update on my blood pressure. It was better. Two digits at the bottom three at the top. I am to monitor it for next few weeks. And I go back.. maybe to update Rx... we'll see. But maybe that now it not related to the vaccine shot. But the Dr office where I received the injection made me stay longer due to my blood pressure. I felt light headed, kindi dizzy. But I think I forgotten to take my blood pressure pill day of 2nd injection.

2021-05-17

Systemic reaction (other): As soon as I awakened this morning a headache came where I took two tylenols you shall take nothing... I was not at where my blood pressure pill was.,..

Release 8 — day 14, dose 2

2021-05-25

Symptoms: My BP is still riding high.I'm logging the numbers for my next blood pressure check.It may have always been higher than usual.But Im presently aware &taking my blood pressure pills. 3 times a day.1on empty stomach and 2 full..

Release 9 — day 42, dose 2

2021-06-22

Symptoms: My blood pressure was right on.. perfect. I went today and got the update.When I got the 2nd shot my blood pressure went up up up...

Healthcare visit (other): THE Clinic

Release 11 — 12 months, dose 2

2022-05-11

Symptoms: I had a bladder infection... followed by strep throat... But all better now... With some antibiotics..The throat thing was interesting... But Dr Office said everything was negative... So all better...

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	Dizziness	✓	✓	✓
HCVO	Memory impairment	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Blood pressure increased	✓	✓	✓
SD	Cystitis	·	·	✓
SD	Hypertension	✓	✓	✓
SD	Pharyngitis streptococcal	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Somnolence	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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