6YM-28670-45213

3 vaccinations 17 coded responses 29 check-ins 17 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 326 / FL
Registered: 2021-01-18

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

2021-01-15
Dose 1 — Moderna
2021-01-18
Registered in v-safe
2021-01-18
Survey response — days 1–6 daily, dose 1
MedDRA: Ageusia, Anosmia — Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness

Free text: Temporary loss of smell and taste

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-01-22
Health check-in — day 7, dose 1
Feeling: Good · Fever · Chills, Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-01-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-05
Survey response — day 21, dose 1
MedDRA: Fatigue, Somnolence — Feeling: Good · Be unable to do your normal daily activities

Free text: Very Tired, sleeping more.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Dose 2 — Moderna
2021-02-12
Health check-in — day 0, dose 2
Feeling: Poor · Site: Pain, Redness · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Good · Site: Pain, Redness, Itching · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Itching all over

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Body itching

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Itching · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-16
Survey response — days 1–6 daily, dose 2
MedDRA: Productive cough, Pruritus, Rhinorrhoea — Feeling: Good · Site: Itching

Free text: Itching, runny nose, phlegmy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — days 1–6 daily, dose 2
MedDRA: Productive cough, Pruritus, Rhinorrhoea — Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness

Free text: Itching all over, runny nose, phlegm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — days 1–6 daily, dose 2
MedDRA: Productive cough, Pruritus, Rhinorrhoea — Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Runny nose, itchy skin, phlegm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — day 7, dose 2
MedDRA: Pruritus, Rhinorrhoea — Feeling: Good · Headache, Joint pains, Fatigue or tiredness

Free text: Itching, runny nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-12
Survey response — day 28, dose 2
MedDRA: Fatigue, Injection site pruritus — Feeling: Fair · Be unable to do your normal daily activities

Free text: Arm where vaccinated started itching again. Fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — day 35, dose 2
MedDRA: Memory impairment — Feeling: Fair · Be unable to do your normal daily activities

Free text: More forgetful than usual

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-16
Survey response — 3 months, dose 2
MedDRA: Injection site pruritus, Injection site swelling, Lethargy, Malaise, Pruritus — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Extreme itching on back and vaccine site that disrupts sleep. Raised bump at vaccine site. Lethargy, generally feeling unwell.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Report sent to call center — 3 months, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-05
Dose 3 — Moderna
2021-11-06
Survey response — days 1–6 daily, dose 3
MedDRA: Haemorrhagic stroke — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: I had a hemmoragic stroke in june 2021

MedDRA releases: 2024-11 · check-in free text available
2021-11-07
Survey response — days 1–6 daily, dose 3
MedDRA: Cerebrovascular accident — Feeling: Fair · Site: Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: I had a stroke in june 2021 after receiving bith doses in the moderna vaccine

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Redness, Swelling, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-11-10
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-12
Health check-in — day 7, dose 3
Feeling: Fair · Site: Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-19
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-26
Survey response — day 21, dose 3
MedDRA: Brain fog, Diarrhoea, Fatigue — Feeling: Poor · Be unable to do your normal daily activities

Free text: Diarreah, fatigue, brain fog,

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Survey response — day 28, dose 3
MedDRA: Fatigue — Feeling: Poor · Be unable to do your normal daily activities

Free text: Very fatigued.

MedDRA releases: 2024-11 · check-in free text available
2021-12-12
Survey response — day 35, dose 3
MedDRA: Brain fog, Fatigue, Oxygen saturation decreased — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Extreme fatigue. Low O2 (have to use my oxygen concentrator more often). Brain fog

MedDRA releases: 2024-11 · check-in free text available
2021-12-17
Survey response — day 42, dose 3
MedDRA: Brain fog, Fatigue — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Fatigue, brain fog

MedDRA releases: 2024-11 · check-in free text available
2022-04-08
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-15	Moderna
2	2021-02-12	Moderna
3	2021-11-05	Moderna	No

Call center

1 call center case

1 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-18

Systemic reaction (other): Temporary loss of smell and taste

Release 3 — day 21, dose 1

2021-02-05

Symptoms: Very Tired, sleeping more.

Release 4 — days 1–6 daily, dose 2

2021-02-13

Systemic reaction (other): Itching all over

2021-02-14

Systemic reaction (other): Body itching

2021-02-16

Systemic reaction (other): Itching, runny nose, phlegmy

2021-02-17

Systemic reaction (other): Itching all over, runny nose, phlegm

2021-02-18

Systemic reaction (other): Runny nose, itchy skin, phlegm

Release 4 — day 7, dose 2

2021-02-19

Systemic reaction (other): Itching, runny nose

Release 5 — day 28, dose 2

2021-03-12

Symptoms: Arm where vaccinated started itching again. Fatigue.

Release 6 — day 35, dose 2

2021-03-20

Symptoms: More forgetful than usual

Release 8 — 3 months, dose 2

2021-05-16

Symptoms: Extreme itching on back and vaccine site that disrupts sleep. Raised bump at vaccine site. Lethargy, generally feeling unwell.

Release 10 — days 1–6 daily, dose 3

2021-11-06

Systemic reaction (other): I had a hemmoragic stroke in june 2021

2021-11-07

Systemic reaction (other): I had a stroke in june 2021 after receiving bith doses in the moderna vaccine

Release 10 — day 21, dose 3

2021-11-26

Symptoms: Diarreah, fatigue, brain fog,

Release 10 — day 28, dose 3

2021-12-03

Symptoms: Very fatigued.

Release 10 — day 35, dose 3

2021-12-12

Symptoms: Extreme fatigue. Low O2 (have to use my oxygen concentrator more often). Brain fog

Release 10 — day 42, dose 3

2021-12-17

Symptoms: Fatigue, brain fog

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	Brain fog	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Lethargy	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Memory impairment	✓	✓	✓
SD	Oxygen saturation decreased	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Somnolence	✓	✓	✓
SRO	Ageusia	✓	✓	✓
SRO	Anosmia	✓	✓	✓
SRO	Cerebrovascular accident	·	·	✓
SRO	Haemorrhagic stroke	·	·	✓
SRO	Productive cough	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓

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