6RZ-97033-47873

3 vaccinations 8 coded responses 20 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 377 / TN
Registered: 2021-01-13

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

2020-12-23
Dose 1 — Moderna
2021-01-13
Registered in v-safe
2021-01-13
Survey response — day 21, dose 1
MedDRA: Headache, Hypersomnia, Injection site erythema, Injection site pain, Injection site swelling, Lethargy — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: Day one and two soreness with raised red area at injection site. By day 5 I was extremely lethargic and experienced a headache. I could not stay awake for two whole days. I was off work at this time for the holidays. By day 8 I was back to work.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Report sent to call center — day 21, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-21
Dose 2 — Moderna
2021-01-21
Health check-in — day 0, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Fatigue or tiredness, Nausea, Vomiting · Be unable to work

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · Headache, Fatigue or tiredness

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-01-25
Survey response — days 1–6 daily, dose 2
MedDRA: Irritability — Feeling: Good · Fatigue or tiredness

Free text: Out of sorts somewhat.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Good

Free text: Foggy headed. Just not myself.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Survey response — days 1–6 daily, dose 2
MedDRA: Eating disorder — Feeling: Good · Fatigue or tiredness, Nausea

Free text: Can not eat chicken????

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-04
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-11
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-18
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-25
Survey response — day 35, dose 2
MedDRA: Fatigue, Nausea, Pregnancy, SARS-CoV-2 test negative — Feeling: Fair

Free text: I am tired moreso than usual plus a I have nausea most days. To the point I thought I was pregnant. Test was negative. I have been this way since second vaccine injection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-17
Pregnancy registry survey
Not pregnant at or since vaccination ·
2021-04-22
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-22
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-01-21
Survey response — 12 months, dose 2
MedDRA: COVID-19, Office visit, Thrombosis — Feeling: Poor · 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: Symptoms: Blood clots and positive to COVID · Healthcare visit (other): Surgery center

MedDRA releases: 2024-11 · check-in free text available
2022-01-21
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)
2022-01-25
Call 1 — Left Voicemail
2022-02-24
Dose 3 — Moderna
2022-05-26
Survey response — 3 months, dose 3
MedDRA: Thrombosis — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Blood clots

MedDRA releases: 2024-11 · check-in free text available
2022-08-25
Survey response — 6 months, dose 3
MedDRA: Cough, Dyspnoea, Respiratory tract congestion — Feeling: Poor · Be unable to work or attend school

Free text: I have chest congestion, short of breath, and cough.

MedDRA releases: 2024-11 · check-in free text available
2023-02-24
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-23	Moderna
2	2021-01-21	Moderna
3	2022-02-24	Moderna	No

Call center

2 call center cases

1 unsuccessful · 1 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 1 — day 21, dose 1

2021-01-13

Symptoms: Day one and two soreness with raised red area at injection site. By day 5 I was extremely lethargic and experienced a headache. I could not stay awake for two whole days. I was off work at this time for the holidays. By day 8 I was back to work.

Release 2 — days 1–6 daily, dose 2

2021-01-25

Systemic reaction (other): Out of sorts somewhat.

2021-01-26

Systemic reaction (other): Foggy headed. Just not myself.

2021-01-27

Systemic reaction (other): Can not eat chicken????

Release 4 — day 35, dose 2

2021-02-25

Symptoms: I am tired moreso than usual plus a I have nausea most days. To the point I thought I was pregnant. Test was negative. I have been this way since second vaccine injection.

Release 11 — 12 months, dose 2

2022-01-21

Symptoms: Blood clots and positive to COVID

Healthcare visit (other): Surgery center

Release 11 — 3 months, dose 3

2022-05-26

Symptoms: Blood clots

Release 12 — 6 months, dose 3

2022-08-25

Symptoms: I have chest congestion, short of breath, and cough.

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	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypersomnia	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Lethargy	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Pregnancy	✓	✓	○
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test negative	✓	✓	○
SD	Thrombosis	·	·	✓
SRO	Eating disorder	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Irritability	✓	✓	✓

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