6XE-13947-27874

4 vaccinations 4 coded responses 31 check-ins 4 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 329 / FL
Registered: 2021-02-19

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

2021-02-12
Dose 1 — Moderna
2021-02-19
Registered in v-safe
2021-02-19
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-12
Dose 2 — Moderna
2021-03-19
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-11
Survey response — 3 months, dose 2
MedDRA: Cough, Eye discharge, Headache, Nasopharyngitis, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Cold. Sore throat, nose and eyes drainage, cough, headache...

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-10
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-01
Dose 3 — Moderna
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-08
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-16
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-22
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-29
Survey response — day 28, dose 3
MedDRA: Hordeolum, Infection, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Stye in left eye. Infection. · Healthcare visit (other): Optometrist

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
Report sent to call center — day 28, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-30
Call 1 — Left Voicemail
2021-12-06
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-13
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-31
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-02
Survey response — 6 months, dose 3
MedDRA: Medical counselling, Oropharyngeal pain, SARS-CoV-2 test, SARS-CoV-2 test positive — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I tested Positive on Friday, April 29, 2022. I most likely have the BA.2 subvariant of Omicron, because started with sore throat. Rx Paxlovid started the evening of 4/29. Have taken 18 of the 30 pills, of the 5 day treatment. · Healthcare visit (other): Home Covid test, followed by contacting Primary Care Provider by phone.

MedDRA releases: 2024-11 · check-in free text available
2022-05-02
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-03
Call 1 — Left Voicemail
2022-05-03
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-09-20
Dose 4 — Moderna
2022-10-08
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-11
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-18
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-25
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-01
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-21
Survey response — 3 months, dose 4
MedDRA: COVID-19 — Feeling: Good · 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: Covid Positive on November 25th thru December 9th. Paxlovid started Nov 25th. 5 days.

MedDRA releases: 2024-11 · check-in free text available
2022-12-21
Report sent to call center — 3 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-22
Call 1 — Left Voicemail
2022-12-23
Call 2 — Left Voicemail
2022-12-23
Call 2 — Left Voicemail
2023-03-23
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-12	Moderna
2	2021-03-12	Moderna
3	2021-11-01	Moderna	No
4	2022-09-20	Moderna	No

Call center

3 call center cases

1 successful · 2 unsuccessful

See the call center timeline

Free text

Release 9 — 3 months, dose 2

2021-06-11

Symptoms: Cold. Sore throat, nose and eyes drainage, cough, headache...

Release 10 — day 28, dose 3

2021-11-29

Symptoms: Stye in left eye. Infection.

Healthcare visit (other): Optometrist

Release 11 — 6 months, dose 3

2022-05-02

Symptoms: I tested Positive on Friday, April 29, 2022. I most likely have the BA.2 subvariant of Omicron, because started with sore throat. Rx Paxlovid started the evening of 4/29. Have taken 18 of the 30 pills, of the 5 day treatment.

Healthcare visit (other): Home Covid test, followed by contacting Primary Care Provider by phone.

Release 12 — 3 months, dose 4

2022-12-21

Symptoms: Covid Positive on November 25th thru December 9th. Paxlovid started Nov 25th. 5 days.

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	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	SARS-CoV-2 test	·	·	✓
SD	Cough	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Eye discharge	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hordeolum	·	·	✓
SD	Infection	·	·	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	SARS-CoV-2 test positive	·	·	✓

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