6P5-30903-56491

3 vaccinations 11 coded responses 21 check-ins 11 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 217 / MD
Registered: 2021-03-13

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

2021-03-07
Dose 1 — Moderna
2021-03-13
Registered in v-safe
2021-03-14
Survey response — day 7, dose 1
MedDRA: Arthralgia — Feeling: Good

Free text: My shoulder is a bit sore on the arm where the shot was

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — day 14, dose 1
MedDRA: Burning sensation, Dry skin, Erythema, Medical counselling, Peripheral swelling, Pruritus — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Arm swelled like a half of a clementine orange-become red and burning. When it finally went down after 2 1/2 days the skin is like fried chicken skin. Lizard skin? Itchy. · Healthcare visit (other): Phone contact a d call back

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-28
Survey response — day 21, dose 1
MedDRA: Headache, Injection site scab — Feeling: Fair

Free text: Headache The hole where the needle went in keeps scabbing but not closing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Dose 2 — Moderna
2021-04-04
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Depressed mood, Headache, Irritability — Feeling: Fair · Headache

Free text: Yes I felt euphoric after the first shot. I had all COVID symptoms at the end of February 2020. The second shot, I feel irritable, have a horrible headache and felt so sad and depressed out of the blue last night.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Chills

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-11
Survey response — day 7, dose 2
MedDRA: Oropharyngeal pain — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-25
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-02
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-09
Survey response — day 35, dose 2
MedDRA: Chills, Nasopharyngitis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Cold symptoms chills

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-04
Survey response — 3 months, dose 2
MedDRA: Ageusia, Anosmia, Headache, Pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Continue to off and on lose smell and taste , headache and achy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-03
Survey response — 6 months, dose 2
MedDRA: Anxiety, Malaise, Mental fatigue, Quarantine — Feeling: Fair

Free text: Im a teacher a d have had several kids and quarantines. I dont know if Im mentally exhausted from worrying or feel sick!

MedDRA releases: 2024-11 · check-in free text available
2021-11-27
Dose 3 — Moderna
2021-12-30
Call 2 — Left Voicemail
2022-04-04
Survey response — 12 months, dose 2
MedDRA: Condition aggravated, Dehydration, Glycosylated haemoglobin increased, Pre-existing disease, Thirst — 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 · Outpatient clinic or urgent care clinic visit

Free text: After booster had severe dehydration and excessive thirst. My A1C jumped through the roof. I believe that I went from pre diabetic to diabetic specifically from this booster. Something went wrong at the exact same time

MedDRA releases: 2024-11 · check-in free text available
2022-04-04
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-05
Call 1 — Left Voicemail
2022-06-01
Survey response — 6 months, dose 3
MedDRA: Alopecia, Asthenia, Blood glucose increased, Glycosylated haemoglobin increased, Headache, Pain, Thirst — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Sugar (A1C) shot through the roof after booster. Excessive thirst, hair loss, headaches, body aches and weakness ongoing.

MedDRA releases: 2024-11 · check-in free text available
2022-06-01
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-06-02
Call 1 — Left Voicemail
2022-06-02
Call 2 — Left Voicemail
2022-06-02
Call 1 — Left Voicemail
2022-11-27
Survey response — 12 months, dose 3
MedDRA: Blood glucose increased, COVID-19, Pre-existing disease — Feeling: Poor · Be unable to work or attend school

Free text: Covid contracted I'm already a long hauler I don't catch anything but the last booster threw my sugar so high I had to stop. I'm a teacher please get the kids vaccinated -add it to the required list

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-07	Moderna
2	2021-04-04	Moderna
3	2021-11-27	Moderna	No

Call center

3 call center cases

3 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 5 — day 7, dose 1

2021-03-14

Systemic reaction (other): My shoulder is a bit sore on the arm where the shot was

Release 6 — day 14, dose 1

2021-03-21

Symptoms: Arm swelled like a half of a clementine orange-become red and burning. When it finally went down after 2 1/2 days the skin is like fried chicken skin. Lizard skin? Itchy.

Healthcare visit (other): Phone contact a d call back

Release 6 — day 21, dose 1

2021-03-28

Symptoms: Headache The hole where the needle went in keeps scabbing but not closing

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): Yes I felt euphoric after the first shot. I had all COVID symptoms at the end of February 2020. The second shot, I feel irritable, have a horrible headache and felt so sad and depressed out of the blue last night.

Release 7 — day 7, dose 2

2021-04-11

Systemic reaction (other): Sore throat

Release 8 — day 35, dose 2

2021-05-09

Symptoms: Cold symptoms chills

Release 9 — 3 months, dose 2

2021-07-04

Symptoms: Continue to off and on lose smell and taste , headache and achy

Release 9 — 6 months, dose 2

2021-10-03

Symptoms: Im a teacher a d have had several kids and quarantines. I dont know if Im mentally exhausted from worrying or feel sick!

Release 11 — 12 months, dose 2

2022-04-04

Symptoms: After booster had severe dehydration and excessive thirst. My A1C jumped through the roof. I believe that I went from pre diabetic to diabetic specifically from this booster. Something went wrong at the exact same time

Release 11 — 6 months, dose 3

2022-06-01

Symptoms: Sugar (A1C) shot through the roof after booster. Excessive thirst, hair loss, headaches, body aches and weakness ongoing.

Release 12 — 12 months, dose 3

2022-11-27

Symptoms: Covid contracted I'm already a long hauler I don't catch anything but the last booster threw my sugar so high I had to stop. I'm a teacher please get the kids vaccinated -add it to the required list

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	Ageusia	✓	✓	✓
SD	Alopecia	·	·	✓
SD	Anosmia	✓	✓	✓
SD	Anxiety	·	·	✓
SD	Asthenia	·	·	✓
SD	Blood glucose increased	·	·	✓
SD	Burning sensation	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Condition aggravated	·	·	✓
SD	COVID-19	·	·	✓
SD	Dehydration	·	·	✓
SD	Dry skin	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Glycosylated haemoglobin increased	·	·	✓
SD	Headache	✓	✓	✓
SD	Injection site scab	✓	✓	✓
SD	Malaise	·	·	✓
SD	Mental fatigue	·	·	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Quarantine	·	·	✓
SD	Thirst	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Depressed mood	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Irritability	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓

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