7RK-55032-99948

3 vaccinations 4 coded responses 19 check-ins 4 free-text entries 3 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 356 / AL
Registered: 2021-06-09

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

Registered dependents

CNY-20305-46210 Child or adolescent in my care · Female · 2022-06-21

Timeline

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

2021-04-12
Dose 1 — Moderna
2021-05-10
Dose 2 — Moderna
2021-06-09
Registered in v-safe
2021-06-09
Survey response — day 28, dose 2
MedDRA: Chills, Fatigue, Feeling hot, Nasopharyngitis, Pain, Pyrexia, Rash, Rash erythematous — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: I had a red warm rash on my arm for a week after my second dose of the vaccine. I had a fever of 102 with horrible body aches and chills that lasted for a few days and extreme exhaustion that lasted for 2 weeks. I currently am having cold symptoms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-15
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-06-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-09
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-11-11
Survey response — 6 months, dose 2
MedDRA: Cholelithiasis, Hyperthyroidism, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Gallstones and hyperthyroidism · Healthcare visit (other): Just normal in person doctor visit with in person testing

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

1 call case(s)
2021-11-12
Call successful
Does not wish to fill out VAERS report
2022-05-13
Dose 3 — Moderna
2022-05-14
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness, Diarrhea

Adult check-in
2022-05-14
Survey response — 12 months, dose 2
MedDRA: Cholecystectomy, Dental care, Tooth extraction — Feeling: Fair · 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: Had to have my gallbladder removed, a tooth pulled, and other dental work done.

MedDRA releases: 2024-11 · check-in free text available
2022-05-14
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-15
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness

Adult check-in
2022-05-16
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness, Diarrhea

Adult check-in
2022-05-17
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2022-05-17
Call 1 — Left Voicemail
2022-05-18
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2022-05-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2022-05-23
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-05-28
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-06-03
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-06-10
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-06-17
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-06-25
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-08-13
Survey response — 3 months, dose 3
MedDRA: Cough, Diarrhoea, Fatigue, Headache, Nausea, Productive cough, Pyrexia, Sinusitis — 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: Headache, diarrhea, cough, sinus infection, fatigue, nausea, phlegm, fever

MedDRA releases: 2024-11 · check-in free text available
2022-08-13
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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-08-16
Call 1 — Left Voicemail
2022-08-16
Call 2 — Left Voicemail
2022-08-16
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-12	Moderna
2	2021-05-10	Moderna
3	2022-05-13	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-11-11	Successful 2021-11-12	Does not wish to fill out VAERS report
2022-05-14	Unsuccessful
2022-08-13	Unsuccessful

Free text

Release 9 — day 28, dose 2

2021-06-09

Symptoms: I had a red warm rash on my arm for a week after my second dose of the vaccine. I had a fever of 102 with horrible body aches and chills that lasted for a few days and extreme exhaustion that lasted for 2 weeks. I currently am having cold symptoms. cut off by CDC

Release 10 — 6 months, dose 2

2021-11-11

Symptoms: Gallstones and hyperthyroidism

Healthcare visit (other): Just normal in person doctor visit with in person testing

Release 11 — 12 months, dose 2

2022-05-14

Symptoms: Had to have my gallbladder removed, a tooth pulled, and other dental work done.

Release 12 — 3 months, dose 3

2022-08-13

Symptoms: Headache, diarrhea, cough, sinus infection, fatigue, nausea, phlegm, fever

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	Chills	✓	✓	✓
SD	Cholecystectomy	·	·	✓
SD	Cholelithiasis	·	·	✓
SD	Cough	·	·	✓
SD	Dental care	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeling hot	✓	✓	✓
SD	Headache	·	·	✓
SD	Hyperthyroidism	·	·	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Nausea	·	·	✓
SD	Pain	✓	✓	✓
SD	Productive cough	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash erythematous	✓	✓	✓
SD	Sinusitis	·	·	✓
SD	Tooth extraction	·	·	✓

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