6CE-32214-62202

3 vaccinations 6 coded responses 40 check-ins 6 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 282 / NC
Registered: 2021-04-16

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

2021-04-16
Registered in v-safe
2021-04-16
Dose 1 — Moderna
2021-04-16
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-19
Survey response — days 1–6 daily, dose 1
MedDRA: Chills, Fatigue, Self-medication — Feeling: Fair · Chills, Fatigue or tiredness

Free text: Evening of 4-17-21 bad chills and deep fatigue, afternoon and evening of 4-18-19, chills and fatigue, took Tylenol

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-23
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-30
Survey response — day 14, dose 1
MedDRA: Fatigue — Feeling: Good

Free text: Remained tired for several days after the 1st shot...just fatigued.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-13
Dose 2 — Moderna
2021-05-13
Survey response — day 0, dose 2
MedDRA: Dizziness, Dyspnoea — Feeling: Fair · Site: Pain

Free text: Light-headed and slight breathing issue immediately after injection, but it reaolved in less than 2 minutes. No similar symptoms sense then. I fell a little Light-headed, but it's not a problem

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
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: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-05-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-20
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-12
Health check-in — 3 months, dose 2
Feeling: Good

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

Adult check-in
2021-11-18
Dose 3 — Moderna
2021-11-18
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-11-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Itching · Fatigue or tiredness

Adult check-in
2021-11-21
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-11-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-23
Survey response — days 1–6 daily, dose 3
MedDRA: Throat irritation — Feeling: Good

Free text: Scratchy throat

MedDRA releases: 2024-11 · check-in free text available
2021-11-24
Survey response — days 1–6 daily, dose 3
MedDRA: Rhinorrhoea — Feeling: Fair

Free text: Sniffles

MedDRA releases: 2024-11 · check-in free text available
2021-11-25
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-02
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-16
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-23
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-31
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-17
Survey response — 3 months, dose 3
MedDRA: Chest discomfort — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: chest tightness

MedDRA releases: 2024-11 · check-in free text available
2022-02-17
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-22
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-05-19
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-20
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-16	Moderna
2	2021-05-13	Moderna
3	2021-11-18	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-19

Systemic reaction (other): Evening of 4-17-21 bad chills and deep fatigue, afternoon and evening of 4-18-19, chills and fatigue, took Tylenol

Release 8 — day 14, dose 1

2021-04-30

Symptoms: Remained tired for several days after the 1st shot...just fatigued.

Release 8 — day 0, dose 2

2021-05-13

Systemic reaction (other): Light-headed and slight breathing issue immediately after injection, but it reaolved in less than 2 minutes. No similar symptoms sense then. I fell a little Light-headed, but it's not a problem

Release 10 — days 1–6 daily, dose 3

2021-11-23

Systemic reaction (other): Scratchy throat

2021-11-24

Systemic reaction (other): Sniffles

Release 11 — 3 months, dose 3

2022-02-17

Symptoms: chest tightness

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
SD	Chest discomfort	·	·	✓
SD	Fatigue	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Rhinorrhoea	·	·	✓
SRO	Self-medication	✓	✓	✓
SRO	Throat irritation	·	·	✓

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