6FM-53253-72840

2 vaccinations 11 coded responses 21 check-ins 11 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 750 / TX
Registered: 2021-01-22

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-01-22
Registered in v-safe
2021-01-22
Dose 1 — Moderna
2021-01-22
Survey response — day 0, dose 1
MedDRA: Hypertension — Feeling: Fair · Site: Pain · Nausea · Be unable to do your normal daily activities

Free text: My blood preasure was high after vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-26
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea, Office visit, Respiratory tract congestion — Feeling: Poor · Site: Pain · Joint pains, Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Congested hard time to breath at morning time and bed time · Healthcare visit (other): Doctors office yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-27
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Heart rate irregular — Feeling: Poor · Site: Pain · Headache

Free text: Very dizzy and irregular heart beats

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea — Feeling: Fair · Site: Pain · Headache

Free text: Shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Survey response — day 7, dose 1
MedDRA: Nausea, Respiratory tract congestion — Feeling: Fair · Site: Pain · Headache, Nausea

Free text: Nausea and like if congested trouble breathing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-15
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-19
Dose 2 — Moderna
2021-02-19
Survey response — day 0, dose 2
MedDRA: Anxiety, Fatigue, Headache, Pre-existing disease — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches

Free text: Tired headache more anxiaty then normal

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Anxiety, Pre-existing disease — Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activities

Free text: I suffer anxiaty and since vacicine is more

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Survey response — days 1–6 daily, dose 2
MedDRA: Anxiety — Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activities

Free text: Anxiaty much more then normal for me

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Survey response — day 7, dose 2
MedDRA: Anxiety — Feeling: Fair · Site: Pain · Headache, Nausea

Free text: Severe anxiaty

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-12
Survey response — day 21, dose 2
MedDRA: Fatigue, Headache, Somnolence — Feeling: Fair · Be unable to do your normal daily activities

Free text: Very tired headache and sleepy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-26
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-08
Call 1 — Left Voicemail
2021-04-08
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-05-21
Survey response — 3 months, dose 2
MedDRA: Anxiety, Dizziness, Office visit, Palpitations, Vertigo — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Dizzines, palpitations, anxiaty, pas out 3cweeks ago vertigo, had a nuclear stress test on wednesday waiting fir results, visit ENT, neurologyst family doctor they do not know what the problem is · Healthcare visit (other): Office visits all

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
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)
2022-02-11
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Moderna
2	2021-02-19	Moderna

Call center

2 call center cases

1 successful · 1 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-22

Systemic reaction (other): My blood preasure was high after vaccine

Release 2 — days 1–6 daily, dose 1

2021-01-26

Systemic reaction (other): Congested hard time to breath at morning time and bed time

Healthcare visit (other): Doctors office yesterday

2021-01-27

Systemic reaction (other): Very dizzy and irregular heart beats

2021-01-28

Systemic reaction (other): Shortness of breath

Release 3 — day 7, dose 1

2021-01-29

Systemic reaction (other): Nausea and like if congested trouble breathing

Release 4 — day 0, dose 2

2021-02-19

Systemic reaction (other): Tired headache more anxiaty then normal

Release 4 — days 1–6 daily, dose 2

2021-02-23

Systemic reaction (other): I suffer anxiaty and since vacicine is more

2021-02-25

Systemic reaction (other): Anxiaty much more then normal for me

Release 4 — day 7, dose 2

2021-02-26

Systemic reaction (other): Severe anxiaty

Release 5 — day 21, dose 2

2021-03-12

Symptoms: Very tired headache and sleepy

Release 8 — 3 months, dose 2

2021-05-21

Symptoms: Dizzines, palpitations, anxiaty, pas out 3cweeks ago vertigo, had a nuclear stress test on wednesday waiting fir results, visit ENT, neurologyst family doctor they do not know what the problem is

Healthcare visit (other): Office visits all

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	✓	✓	✓
SD	Anxiety	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Palpitations	✓	✓	✓
SD	Somnolence	✓	✓	✓
SD	Vertigo	✓	✓	✓
SRO	Anxiety	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Heart rate irregular	✓	✓	✓
SRO	Hypertension	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓

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