6BP-13815-40962

4 vaccinations 9 coded responses 32 check-ins 8 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 379 / TN
Registered: 2021-01-02

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

2021-01-02
Registered in v-safe
2021-01-02
Dose 1 — Moderna
2021-01-02
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness, Diarrhea

Adult check-in
2021-01-03
Survey response — days 1–6 daily, dose 1
MedDRA: Self-medication — Feeling: Good · Site: Pain · Diarrhea

Free text: I took Tylenol

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-04
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Good

Free text: Arm slightly sore.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-09
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-16
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-23
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-30
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-01
Dose 2 — Moderna
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Pain, Pyrexia — Feeling: Good · Chills

Free text: I have not reported my symptoms following my shot last Monday. They were somewhat severe high fever aches pains etc That was Monday night til Wed morning.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-02-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-03
Survey response — 3 months, dose 2
MedDRA: Cough, Medical counselling, Nasopharyngitis, Pyrexia, Urinary tract infection — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: UTI, cold and cough and fever · Healthcare visit (other): Talked to my doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-02
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-24
Dose 3 — Moderna
2021-10-25
Survey response — day 28, dose 3
MedDRA: Pyrexia — Feeling: Good · Be unable to do your normal daily activities

Free text: Had fever for about 15 hours 6-8 hours after the vacvine

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-05
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-25
Survey response — 6 months, dose 3
MedDRA: COVID-19, Hip arthroplasty — Feeling: Good · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Had Covid and had a hip replacement

MedDRA releases: 2024-11 · check-in free text available
2022-03-25
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2022-03-28
Call successful
Does not wish to fill out VAERS report
2022-03-28
Call successful
Does not wish to fill out VAERS report
2022-03-31
Dose 4 — Moderna
2022-04-14
Survey response — day 14, dose 4
MedDRA: Adverse reaction, Laboratory test abnormal — Feeling: Good · Be unable to do your normal daily activities

Free text: Tested positive for Diabetes and I had a reaction from the last Covid booster

MedDRA releases: 2024-11 · check-in free text available
2022-04-21
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-04-28
Health check-in — day 28, dose 4
Feeling: Good

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

Adult check-in
2022-05-12
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-06-30
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-01
Survey response — 6 months, dose 4
MedDRA: Exposure to SARS-CoV-2 — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Was exposed to Covid

MedDRA releases: 2024-11 · check-in free text available
2022-10-01
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-10-04
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-31
Survey response — 12 months, dose 4
MedDRA: Cardiac disorder, Herpes zoster, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-03-31
Report sent to call center — 12 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2023-04-04
Call 1 — Requested Callback
2023-04-04
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-02	Moderna
2	2021-02-01	Moderna
3	2021-09-24	Moderna	No
4	2022-03-31	Moderna	No

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-03

Systemic reaction (other): I took Tylenol

2021-01-04

Systemic reaction (other): Arm slightly sore.

Release 3 — days 1–6 daily, dose 2

2021-02-07

Systemic reaction (other): I have not reported my symptoms following my shot last Monday. They were somewhat severe high fever aches pains etc That was Monday night til Wed morning.

Release 8 — 3 months, dose 2

2021-05-03

Symptoms: UTI, cold and cough and fever

Healthcare visit (other): Talked to my doctor

Release 10 — day 28, dose 3

2021-10-25

Symptoms: Had fever for about 15 hours 6-8 hours after the vacvine

Release 11 — 6 months, dose 3

2022-03-25

Symptoms: Had Covid and had a hip replacement

Release 11 — day 14, dose 4

2022-04-14

Symptoms: Tested positive for Diabetes and I had a reaction from the last Covid booster

Release 12 — 6 months, dose 4

2022-10-01

Symptoms: Was exposed to Covid

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	✓	✓	✓
HCVO	Office visit	·	·	✓
SD	Adverse reaction	·	·	✓
SD	Cardiac disorder	·	·	✓
SD	Cough	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Diabetes mellitus	·	·	○
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Herpes zoster	·	·	✓
SD	Hip arthroplasty	·	·	✓
SD	Laboratory test abnormal	·	·	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Urinary tract infection	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Unevaluable event	○	○	○

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