8QC-45820-35646

4 vaccinations 14 coded responses 50 check-ins 13 free-text entries 2 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 432 / OH
Registered: 2020-12-29

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

Registered dependents

QVP-27990-99202 Child or adolescent in my care · Male · 2022-06-23

N9J-84475-44690 Child or adolescent in my care · Male · 2023-04-12

Timeline

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

2020-12-29
Registered in v-safe
2020-12-29
Dose 1 — Moderna
2020-12-29
Survey response — day 0, dose 1
MedDRA: Headache — Feeling: Good · Site: Pain · Headache

Free text: I don't think the HA is related I just didn't treat it well yesterday like I should have

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches

Adult check-in
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-05
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Survey response — day 14, dose 1
MedDRA: Injection site pain, Pain — Feeling: Good · Be unable to do your normal daily activities

Free text: Pain in arm at site of injection. Was worsening with use of arm - had to decrease use of that are specifically twisting and weight bearing. Felt like a pulled muscle and attribute to vaccine due to site of pain and no other cause.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-26
Dose 2 — Moderna
2021-01-26
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Fever · None

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

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

Adult check-in
2021-02-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-27
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-03
Dose 3 — Moderna
2021-11-03
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-05
Survey response — days 1–6 daily, dose 3
MedDRA: Respiratory tract congestion, SARS-CoV-2 test negative, Secretion discharge — Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea

Free text: Congestion and mucous - Covid test negative this morning

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Survey response — days 1–6 daily, dose 3
MedDRA: Nasal congestion, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Fair

Free text: Still nasal congestion, runny nose, and was Covid negative yesterday

MedDRA releases: 2024-11 · check-in free text available
2021-11-07
Survey response — days 1–6 daily, dose 3
MedDRA: Breast feeding, Nasopharyngitis, Respiratory tract congestion, Rhinorrhoea — Feeling: Fair · Fatigue or tiredness

Free text: Congestion and runny nose having a cold and waking up for an infant vs side effects. He is nursing and also has signs of a cold

MedDRA releases: 2024-11 · check-in free text available
2021-11-11
Survey response — day 7, dose 3
MedDRA: Cough — Feeling: Fair · Fatigue or tiredness

Free text: Persistent cough

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
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
2021-12-17
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-02
Survey response — 3 months, dose 3
MedDRA: COVID-19, Cough, Pre-existing disease, Pregnancy, Respiratory tract congestion, Sputum purulent, Unevaluable event — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Covid + and pregnant. Symptoms of Covid were mild - 1-2 days of purulent sputum x 1 upon waking. Also had mild dry cough and congestion but those were ongoing prior and I had tested negative several times. Only unable to go to work d/t quarantine.

MedDRA releases: 2024-11 · check-in free text available
2022-05-04
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-15
Dose 4 — Moderna
2022-09-16
Survey response — days 1–6 daily, dose 4
MedDRA: Insomnia, Pregnancy — Feeling: Good · Site: Pain

Free text: Trouble sleeping but I am pregnant and this was already present

MedDRA releases: 2024-11 · check-in free text available
2022-09-17
Survey response — days 1–6 daily, dose 4
MedDRA: Pregnancy — Feeling: Good · Muscle or body aches

Free text: Baseline - due to pregnancy

MedDRA releases: 2024-11 · check-in free text available
2022-09-18
Survey response — days 1–6 daily, dose 4
MedDRA: Pregnancy — Feeling: Good · Muscle or body aches

Free text: Back pain due to pregnancy- not nee

MedDRA releases: 2024-11 · check-in free text available
2022-09-20
Survey response — days 1–6 daily, dose 4
MedDRA: Pregnancy — Feeling: Good · Fatigue or tiredness

Free text: Due to pregnancy

MedDRA releases: 2024-11 · check-in free text available
2022-09-21
Survey response — days 1–6 daily, dose 4
MedDRA: Pregnancy — Feeling: Good · Muscle or body aches

Free text: Due to pregnancy

MedDRA releases: 2024-11 · check-in free text available
2022-09-24
Survey response — day 7, dose 4
MedDRA: Delivery, Unevaluable event — Feeling: Good · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Systemic reaction (other): Just gave birth so likely not related · Healthcare visit (other): For vaginal feline

MedDRA releases: 2024-11 · check-in free text available
2022-09-24
Report sent to call center — day 7, dose 4
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2022-09-27
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-01
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-06
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-13
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-20
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-10-27
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-15
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-16
Survey response — 6 months, dose 4
MedDRA: Unevaluable event — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-29	Moderna
2	2021-01-26	Moderna
3	2021-11-03	Moderna	No
4	2022-09-15	Moderna	No

Call center

2 call center cases

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

See the call center timeline

Free text

Release 1 — day 0, dose 1

2020-12-29

Systemic reaction (other): I don't think the HA is related I just didn't treat it well yesterday like I should have

Release 1 — day 14, dose 1

2021-01-12

Symptoms: Pain in arm at site of injection. Was worsening with use of arm - had to decrease use of that are specifically twisting and weight bearing. Felt like a pulled muscle and attribute to vaccine due to site of pain and no other cause.

Release 10 — days 1–6 daily, dose 3

2021-11-05

Systemic reaction (other): Congestion and mucous - Covid test negative this morning

2021-11-06

Systemic reaction (other): Still nasal congestion, runny nose, and was Covid negative yesterday

2021-11-07

Systemic reaction (other): Congestion and runny nose having a cold and waking up for an infant vs side effects. He is nursing and also has signs of a cold

Release 10 — day 7, dose 3

2021-11-11

Systemic reaction (other): Persistent cough

Release 11 — 3 months, dose 3

2022-02-02

Symptoms: Covid + and pregnant. Symptoms of Covid were mild - 1-2 days of purulent sputum x 1 upon waking. Also had mild dry cough and congestion but those were ongoing prior and I had tested negative several times. Only unable to go to work d/t quarantine.

Release 12 — days 1–6 daily, dose 4

2022-09-16

Systemic reaction (other): Trouble sleeping but I am pregnant and this was already present

2022-09-17

Systemic reaction (other): Baseline - due to pregnancy

2022-09-18

Systemic reaction (other): Back pain due to pregnancy- not nee

2022-09-20

Systemic reaction (other): Due to pregnancy

2022-09-21

Systemic reaction (other): Due to pregnancy

Release 12 — day 7, dose 4

2022-09-24

Systemic reaction (other): Just gave birth so likely not related

Healthcare visit (other): For vaginal feline

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	Unevaluable event	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Injection site pain	✓	✓	✓
SD	Movement disorder	○	○	○
SD	Pain	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Pregnancy	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Sputum purulent	·	·	✓
SD	Unevaluable event	·	·	✓
SRO	Breast feeding	·	·	✓
SRO	Cough	·	·	✓
SRO	Delivery	·	·	✓
SRO	Headache	✓	✓	✓
SRO	Insomnia	·	·	✓
SRO	Nasal congestion	·	·	✓
SRO	Nasopharyngitis	·	·	✓
SRO	Pregnancy	·	·	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	Rhinorrhoea	·	·	✓
SRO	SARS-CoV-2 test negative	·	·	✓
SRO	Secretion discharge	·	·	✓

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