9QB-29768-56995

3 vaccinations 11 coded responses 34 check-ins 11 free-text entries 4 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 920 / CA
Registered: 2020-12-23

Relationship: Self
Race: Native Hawaiian or other Pacific Islander
Ethnicity: Not Hispanic or Latino

Registered dependents

VFS-12682-13114 Child or adolescent in my care · Male · 2021-11-22

BMT-11545-87982 Child or adolescent in my care · Male · 2022-11-26

Timeline

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

2020-12-23
Registered in v-safe
2020-12-23
Dose 1 — Moderna
2020-12-23
Health check-in — day 0, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2020-12-24
Survey response — days 1–6 daily, dose 1
MedDRA: Ageusia, Oropharyngeal pain — Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activities

Free text: Mild loss of taste, sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-24
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2020-12-25
Survey response — days 1–6 daily, dose 1
MedDRA: Ageusia, Oropharyngeal pain, Vertigo — Feeling: Fair · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: mild sore throat, vertigo, mild loss of taste

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-25
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2020-12-26
Survey response — days 1–6 daily, dose 1
MedDRA: Ageusia, SARS-CoV-2 test — Feeling: Good · Fatigue or tiredness, Nausea · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Covid test today to follow up for loss of taste on 12/24. No site open on 12/25

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-26
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2020-12-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness, Nausea

Adult check-in
2020-12-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-30
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2020-12-30
Report sent to call center — day 7, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-06
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-08
Call 1 — Left Voicemail
2021-01-13
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-14
Call 2 — Left Voicemail
2021-01-19
Call 3 — Left Voicemail
2021-01-20
Dose 2 — Moderna
2021-01-20
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-01-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-01-23
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good · Fatigue or tiredness

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Survey response — days 1–6 daily, dose 2
MedDRA: Vertigo — Feeling: Good · Joint pains, Muscle or body aches

Free text: Vertigo

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Survey response — days 1–6 daily, dose 2
MedDRA: Vertigo — Feeling: Good

Free text: Vertigo

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-01-27
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-03
Survey response — day 14, dose 2
MedDRA: Pruritus — Feeling: Good

Free text: Upper Body itching occasionally

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — day 21, dose 2
MedDRA: Arthralgia, Lymph node pain — Feeling: Good

Free text: Joint soreness in ankles, soreness in lymph node locations under axilla

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — day 28, dose 2
MedDRA: Feeling abnormal, Memory impairment — Feeling: Good

Free text: Memory issues, brain fog forgetting words during conversations. Happens occasionally

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — day 35, dose 2
Feeling: Good

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

Adult check-in
2021-04-23
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-22
Dose 3 — Moderna
2021-11-22
Survey response — day 0, dose 3
MedDRA: Chest discomfort — Feeling: Good

Free text: Chest tightness

MedDRA releases: 2024-11 · check-in free text available
2021-11-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-02
Survey response — day 7, dose 3
MedDRA: Palpitations — Feeling: Fair · Be unable to do your normal daily activities

Free text: Palpitations

MedDRA releases: 2024-11 · check-in free text available
2021-12-06
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-23
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-27
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-21
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-23
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-26
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-23	Moderna
2	2021-01-20	Moderna
3	2021-11-22	Moderna	No

Call center

4 call center cases

4 unsuccessful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-24

Systemic reaction (other): Mild loss of taste, sore throat

2020-12-25

Systemic reaction (other): mild sore throat, vertigo, mild loss of taste

2020-12-26

Healthcare visit (other): Covid test today to follow up for loss of taste on 12/24. No site open on 12/25

Release 2 — days 1–6 daily, dose 2

2021-01-23

Systemic reaction (other): Dizziness

2021-01-24

Systemic reaction (other): Vertigo

2021-01-25

Systemic reaction (other): Vertigo

Release 3 — day 14, dose 2

2021-02-03

Symptoms: Upper Body itching occasionally

Release 4 — day 21, dose 2

2021-02-10

Symptoms: Joint soreness in ankles, soreness in lymph node locations under axilla

Release 4 — day 28, dose 2

2021-02-17

Symptoms: Memory issues, brain fog forgetting words during conversations. Happens occasionally

Release 10 — day 0, dose 3

2021-11-22

Systemic reaction (other): Chest tightness

Release 10 — day 7, dose 3

2021-12-02

Systemic reaction (other): Palpitations

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	Ageusia	✓	✓	✓
HCVO	SARS-CoV-2 test	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Lymph node pain	✓	✓	✓
SD	Memory impairment	✓	✓	✓
SD	Pruritus	✓	✓	✓
SRO	Ageusia	✓	✓	✓
SRO	Chest discomfort	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Palpitations	·	·	✓
SRO	Vertigo	✓	✓	✓

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