92E-73886-50977

5 vaccinations 3 coded responses 37 check-ins 3 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 606 / IL
Registered: 2021-03-09

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-02-08
Dose 1 — Moderna
2021-03-09
Registered in v-safe
2021-03-09
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-10
Dose 2 — Moderna
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-07
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-14
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-21
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-09
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-08
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Dose 3 — Moderna
2021-10-24
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness

Adult check-in
2021-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-29
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-05
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-19
Survey response — day 28, dose 3
MedDRA: Fatigue, Myalgia — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Fatigue, muscle aches

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Report sent to call center — day 28, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-26
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-30
Call 3 — Left Voicemail
2021-12-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-21
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-08
Dose 4 — Moderna
2022-04-22
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-15
Survey response — day 35, dose 4
MedDRA: Breast mass, Endometriosis, Mammogram abnormal, Unevaluable event, Uterine dilation and curettage — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Breast mass found on mammogram. Biopsy results are pending . D and C done 1/2022 for endometriosis. · Healthcare visit (other): Biopsy done

MedDRA releases: 2024-11 · check-in free text available
2022-05-15
Report sent to call center — day 35, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-17
Call 1 — Left Voicemail
2022-05-17
Call 1 — Left Voicemail
2022-05-20
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-08
Survey response — 3 months, dose 4
MedDRA: Breast cancer, Surgery — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Diagnosed with Breast Cancer · Healthcare visit (other): Biopsy and Surgery

MedDRA releases: 2024-11 · check-in free text available
2022-07-08
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-07-11
Call 2 — Left Voicemail
2022-07-11
Call 2 — Left Voicemail
2022-07-11
Call 1 — Left Voicemail
2022-10-07
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2022-10-29
Dose 5 — Moderna
2022-11-30
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-12-03
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-12-10
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-28
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-04-29
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-08	Moderna
2	2021-03-10	Moderna
3	2021-10-22	Moderna	No
4	2022-04-08	Moderna	No
5	2022-10-29	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-11-19	Unsuccessful
2022-05-15	Unsuccessful
2022-07-08	Unsuccessful

Free text

Release 10 — day 28, dose 3

2021-11-19

Symptoms: Fatigue, muscle aches

Release 11 — day 35, dose 4

2022-05-15

Symptoms: Breast mass found on mammogram. Biopsy results are pending . D and C done 1/2022 for endometriosis.

Healthcare visit (other): Biopsy done

Release 12 — 3 months, dose 4

2022-07-08

Symptoms: Diagnosed with Breast Cancer

Healthcare visit (other): Biopsy and Surgery

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	Surgery	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Breast cancer	·	·	✓
SD	Breast mass	·	·	✓
SD	Endometriosis	·	·	✓
SD	Fatigue	·	·	✓
SD	Mammogram abnormal	·	·	✓
SD	Myalgia	·	·	✓
SD	Uterine dilation and curettage	·	·	✓

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