85W-19029-30557

4 vaccinations 5 coded responses 32 check-ins 5 free-text entries 5 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 786 / TX
Registered: 2021-02-22

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

Registered dependents

R9D-17592-60808 Child or adolescent in my care · Female · 2022-06-25

Timeline

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

2021-02-22
Registered in v-safe
2021-02-22
Dose 1 — Moderna
2021-02-22
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling, Itching · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-26
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — day 7, dose 1
Feeling: Fair · Fatigue or tiredness, Nausea

Adult check-in
2021-03-08
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-15
Survey response — day 21, dose 1
MedDRA: Diarrhoea, Migraine, Nausea — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Nausea, migraines, diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
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)
2021-03-22
Survey response — day 28, dose 1
MedDRA: Dizziness, Headache, Pyrexia — Feeling: Fair · 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: Headache, dizziness, fever

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Report sent to call center — day 28, dose 1
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)
2021-03-25
Dose 2 — Moderna
2021-03-25
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-06
Call 1 — Left Voicemail
2021-04-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-17
Survey response — day 21, dose 2
MedDRA: Dizziness, Pyrexia, Respiratory tract congestion — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: Low fever dizziness congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-07
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-09-23
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-12
Dose 3 — Moderna
2021-10-28
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-04
Survey response — day 21, dose 3
MedDRA: Abdominal pain upper, Back pain, Cholelithiasis — 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: Upper abdominal pain and back pain. Suspected gallstones

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Report sent to call center — day 21, 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)
2021-11-05
Call 1 — Left Voicemail
2021-11-09
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-16
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-23
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-11
Survey response — 3 months, dose 3
MedDRA: Office visit, Postural orthostatic tachycardia syndrome — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Positional orthostatic tachycardia syndrome · Healthcare visit (other): Cardiologist

MedDRA releases: 2024-11 · check-in free text available
2022-01-11
Report sent to call center — 3 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-13
Call 1 — Left Voicemail
2022-04-12
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-06-27
Dose 4 — Moderna
2022-08-01
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-08-10
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-22	Moderna
2	2021-03-25	Moderna
3	2021-10-12	Moderna	No
4	2022-06-27	Moderna	No

Call center

5 call center cases

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

See the call center timeline

Free text

Release 5 — day 21, dose 1

2021-03-15

Symptoms: Nausea, migraines, diarrhea

Release 6 — day 28, dose 1

2021-03-22

Symptoms: Headache, dizziness, fever

Release 7 — day 21, dose 2

2021-04-17

Symptoms: Low fever dizziness congestion

Release 10 — day 21, dose 3

2021-11-04

Symptoms: Upper abdominal pain and back pain. Suspected gallstones

Release 10 — 3 months, dose 3

2022-01-11

Symptoms: Positional orthostatic tachycardia syndrome

Healthcare visit (other): Cardiologist

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	Abdominal pain upper	·	·	✓
SD	Back pain	·	·	✓
SD	Cholelithiasis	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Migraine	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Postural orthostatic tachycardia syndrome	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓

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