6XT-28059-36015

4 vaccinations 12 coded responses 47 check-ins 11 free-text entries 4 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 802 / CO
Registered: 2021-01-17

Relationship: Self
Race: Multiracial
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-01-17
Registered in v-safe
2021-01-17
Dose 1 — Moderna
2021-01-17
Survey response — day 0, dose 1
MedDRA: Presyncope — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Vasovagal response

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-18
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-22
Survey response — days 1–6 daily, dose 1
MedDRA: Acne, Injection site inflammation — Feeling: Good

Free text: I figured out after my report on 1/18 that I did have inflammation near the injection site (armpit pimples)

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: Good · None

Adult check-in
2021-01-24
Health check-in — day 7, dose 1
Feeling: Good · None

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

Adult check-in
2021-02-07
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-14
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-16
Dose 2 — Moderna
2021-02-16
Health check-in — day 0, dose 2
Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-18
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-17
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-03
Dose 3 — Pfizer-BioNTech
2021-11-03
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-11-04
Survey response — days 1–6 daily, dose 3
MedDRA: Acne — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Back acne

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Survey response — days 1–6 daily, dose 3
MedDRA: Acne — Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Acne

MedDRA releases: 2024-11 · check-in free text available
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-10
Survey response — day 7, dose 3
MedDRA: Hypoglycaemia — Feeling: Fair

Free text: I had a hypoglycemia episode, which is unusual for me

MedDRA releases: 2024-11 · check-in free text available
2021-11-17
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-24
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-01
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-08
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-15
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-02-04
Survey response — 3 months, dose 3
MedDRA: Depression — Feeling: Good · 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: Diagnosed for depression

MedDRA releases: 2024-11 · check-in free text available
2022-02-04
Report sent to call center — 3 months, dose 3
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)
2022-02-10
Call 1 — Left Voicemail
2022-05-06
Survey response — 6 months, dose 3
MedDRA: Obsessive-compulsive disorder — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: OCD diagnosis

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-09
Call 3 — Left Voicemail
2022-05-09
Call 2 — Left Voicemail
2022-09-12
Dose 4 — Moderna
2022-09-13
Survey response — days 1–6 daily, dose 4
MedDRA: Orthostatic hypotension — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Positional low blood pressure

MedDRA releases: 2024-11 · check-in free text available
2022-09-14
Survey response — days 1–6 daily, dose 4
MedDRA: Surgery, Tinnitus — Feeling: Good · Site: Pain, Redness · Fatigue or tiredness, Abdominal pain

Free text: Increased tinitus . Possible increase in pain august surgery site

MedDRA releases: 2024-11 · check-in free text available
2022-09-16
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-09-18
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Joint pains

Adult check-in
2022-09-19
Health check-in — day 7, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-09-26
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-03
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-10-10
Survey response — day 28, dose 4
MedDRA: Fatigue, Malaise — Feeling: Fair

Free text: Fatigue starting today, and that feeling that I'm fighting off an illness. No fever.

MedDRA releases: 2024-11 · check-in free text available
2022-10-17
Survey response — day 35, dose 4
MedDRA: Cough, Nasopharyngitis, Oropharyngeal pain, Respiratory tract congestion — Feeling: Poor · Be unable to work or attend school

Free text: Common cold symptoms (sore throat, cough, congestion)

MedDRA releases: 2024-11 · check-in free text available
2022-10-24
Health check-in — day 42, dose 4
Feeling: Poor

Adult check-in
2022-12-12
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-15
Survey response — 6 months, dose 4
MedDRA: Mass — Feeling: Good · 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

MedDRA releases: 2024-11
2023-03-15
Report sent to call center — 6 months, dose 4
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)
2023-03-16
Call 2 — Left Voicemail
2023-03-16
Call 1 — Left Voicemail
2023-03-16
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-17	Moderna
2	2021-02-16	Moderna
3	2021-11-03	Pfizer-BioNTech	No
4	2022-09-12	Moderna	No

Call center

4 call center cases

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

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-17

Systemic reaction (other): Vasovagal response

Release 2 — days 1–6 daily, dose 1

2021-01-22

Systemic reaction (other): I figured out after my report on 1/18 that I did have inflammation near the injection site (armpit pimples)

Release 10 — days 1–6 daily, dose 3

2021-11-04

Systemic reaction (other): Back acne

2021-11-05

Systemic reaction (other): Acne

Release 10 — day 7, dose 3

2021-11-10

Systemic reaction (other): I had a hypoglycemia episode, which is unusual for me

Release 11 — 3 months, dose 3

2022-02-04

Symptoms: Diagnosed for depression

Release 11 — 6 months, dose 3

2022-05-06

Symptoms: OCD diagnosis

Release 12 — days 1–6 daily, dose 4

2022-09-13

Systemic reaction (other): Positional low blood pressure

2022-09-14

Systemic reaction (other): Increased tinitus . Possible increase in pain august surgery site

Release 12 — day 28, dose 4

2022-10-10

Symptoms: Fatigue starting today, and that feeling that I'm fighting off an illness. No fever.

Release 12 — day 35, dose 4

2022-10-17

Symptoms: Common cold symptoms (sore throat, cough, congestion)

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
SD	Cough	·	·	✓
SD	Depression	·	·	✓
SD	Fatigue	·	·	✓
SD	Malaise	·	·	✓
SD	Mass	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Obsessive-compulsive disorder	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SRO	Acne	✓	✓	✓
SRO	Hypoglycaemia	·	·	✓
SRO	Injection site inflammation	✓	✓	✓
SRO	Orthostatic hypotension	·	·	✓
SRO	Presyncope	✓	✓	✓
SRO	Surgery	·	·	✓
SRO	Tinnitus	·	·	✓

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