6PC-21764-83505

3 vaccinations 8 coded responses 29 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 454 / OH
Registered: 2021-04-24

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

2021-03-24
Dose 1 — Moderna
2021-04-22
Dose 2 — Moderna
2021-04-24
Registered in v-safe
2021-04-24
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Fatigue, Headache, Pain, Pyrexia — Feeling: Fair · Site: Pain · Fever · Muscle or body aches · Be unable to do your normal daily activities

Free text: Night and day after vaccine had chills, bad body aches, fever as high as 101.7, headache, tired,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Itching · Fatigue or tiredness

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-29
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-06
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-27
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-22
Survey response — 3 months, dose 2
MedDRA: Chest discomfort — Feeling: Good

Free text: I have been feeling some discomfort in chest at times, kinda hard to explain, doesn't hurt and I can breathe fine , just uncomfortable at times

MedDRA releases: 2024-11 · check-in free text available
2021-10-21
Survey response — 6 months, dose 2
MedDRA: Malaise, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I have been I'll for almost a week, doctor put me on zpack. · Healthcare visit (other): Office visit

MedDRA releases: 2024-11 · check-in free text available
2021-10-21
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-24
Call 1 — Left Voicemail
2021-10-27
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-12-19
Dose 3 — Moderna
2021-12-19
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-12-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-21
Survey response — days 1–6 daily, dose 3
MedDRA: Chills, Fatigue — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Really bad chills yesterday and very tired

MedDRA releases: 2024-11 · check-in free text available
2021-12-22
Survey response — days 1–6 daily, dose 3
MedDRA: Pain in extremity — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches

Free text: Arm still sore

MedDRA releases: 2024-11 · check-in free text available
2021-12-23
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Mass, Neck mass — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness

Free text: I found a couple lumps around front of shoulder neck area, and soreness under armpit of shot side

MedDRA releases: 2024-11 · check-in free text available
2021-12-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-26
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-01-02
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-09
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-16
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-23
Survey response — day 35, dose 3
MedDRA: Office visit, Photopsia, Vitreous floaters — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: I have floaters and occasional flashes in left eye. Not sure if that is relevant. · Healthcare visit (other): Eye doctor

MedDRA releases: 2024-11 · check-in free text available
2022-01-23
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-24
Call 1 — Left Voicemail
2022-01-30
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-20
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-19
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-12-19
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-24	Moderna
2	2021-04-22	Moderna
3	2021-12-19	Moderna	No

Call center

2 call center cases

1 successful · 1 unsuccessful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-24

Systemic reaction (other): Night and day after vaccine had chills, bad body aches, fever as high as 101.7, headache, tired,

2021-04-25

Systemic reaction (other): Dizziness

Release 9 — 3 months, dose 2

2021-07-22

Symptoms: I have been feeling some discomfort in chest at times, kinda hard to explain, doesn't hurt and I can breathe fine , just uncomfortable at times

Release 10 — 6 months, dose 2

2021-10-21

Symptoms: I have been I'll for almost a week, doctor put me on zpack.

Healthcare visit (other): Office visit

Release 10 — days 1–6 daily, dose 3

2021-12-21

Systemic reaction (other): Really bad chills yesterday and very tired

2021-12-22

Systemic reaction (other): Arm still sore

2021-12-23

Systemic reaction (other): I found a couple lumps around front of shoulder neck area, and soreness under armpit of shot side

Release 11 — day 35, dose 3

2022-01-23

Symptoms: I have floaters and occasional flashes in left eye. Not sure if that is relevant.

Healthcare visit (other): Eye doctor

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	Chest discomfort	·	·	✓
SD	Malaise	·	·	✓
SD	Photopsia	·	·	✓
SD	Vitreous floaters	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Chills	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Mass	·	·	✓
SRO	Neck mass	·	·	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	·	·	✓
SRO	Pyrexia	✓	✓	✓

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