9RC-13218-99926

4 vaccinations 10 coded responses 49 check-ins 10 free-text entries 3 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 805 / CO
Registered: 2021-03-25

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

Registered dependents

C8D-17419-50668 Child or adolescent in my care · Female · 2021-11-05

Timeline

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

2021-03-24
Dose 1 — Moderna
2021-03-25
Registered in v-safe
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-01
Survey response — day 7, dose 1
MedDRA: Urinary tract infection — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Urinary track infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-08
Survey response — day 14, dose 1
MedDRA: Urinary tract infection — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Urinary tract infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

no matching call case
2021-04-14
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-20
Dose 2 — Moderna
2021-04-21
Survey response — days 1–6 daily, dose 2
MedDRA: Confusional state, Dizziness, Memory impairment — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Brain/mental- trouble remembering things, a little confused at times; dizziness/ light headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain, Chest pain — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: My armpit and chest are particularly sore/painful on the side I received my shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-27
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-04
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-18
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-25
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-01
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-07
Call 1 — Left Voicemail
2021-07-20
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-19
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-29
Dose 3 — Moderna
2021-10-29
Survey response — day 0, dose 3
MedDRA: Brain fog — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Brain fog

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Survey response — days 1–6 daily, dose 3
MedDRA: Brain fog — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Brain Fog

MedDRA releases: 2024-11 · check-in free text available
2021-10-31
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Swollen lymph node in armpit

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain, Redness

Free text: Swollen lymph nodes in armpit of arm I received the shot in.

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-05
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-12
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 0, dose 2, dependent
Feeling: Good · None

Adult check-in
2021-12-03
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-11
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-29
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-29
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-09
Dose 4 — Moderna
2022-09-10
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-09-11
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2022-09-12
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Redness · Joint pains

Adult check-in
2022-09-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-09-16
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-09-23
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-02
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-07
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-14
Survey response — day 35, dose 4
MedDRA: Brain fog, Malaise, Oropharyngeal pain, Pain — 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: Sore throat, malaise, body aches, brain fog

MedDRA releases: 2024-11 · check-in free text available
2022-10-14
Report sent to call center — day 35, dose 4
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)
2022-10-17
Call successful
Not applicable - Accidental Reporting
2022-10-17
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-21
Survey response — day 42, dose 4
MedDRA: Cough, Dyspnoea, Fatigue — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Cough, trouble breathing, fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-10-21
Report sent to call center — day 42, dose 4
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 · Emergency room or emergency department visit · 1 call case(s)
2022-10-24
Call 1 — Left Voicemail
2022-10-26
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-09
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-12
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-24	Moderna
2	2021-04-20	Moderna
3	2021-10-29	Moderna	No
4	2022-09-09	Moderna	No

Call center

3 call center cases

3 successful

1 check-in flagged for a call with no call center case on record

See the call center timeline

Free text

Release 6 — day 7, dose 1

2021-04-01

Systemic reaction (other): Urinary track infection

Release 7 — day 14, dose 1

2021-04-08

Symptoms: Urinary tract infection

Release 7 — days 1–6 daily, dose 2

2021-04-21

Systemic reaction (other): Brain/mental- trouble remembering things, a little confused at times; dizziness/ light headed

2021-04-22

Systemic reaction (other): My armpit and chest are particularly sore/painful on the side I received my shot.

Release 10 — day 0, dose 3

2021-10-29

Systemic reaction (other): Brain fog

Release 10 — days 1–6 daily, dose 3

2021-10-30

Systemic reaction (other): Brain Fog

2021-10-31

Systemic reaction (other): Swollen lymph node in armpit

2021-11-02

Systemic reaction (other): Swollen lymph nodes in armpit of arm I received the shot in.

Release 12 — day 35, dose 4

2022-10-14

Symptoms: Sore throat, malaise, body aches, brain fog

Release 12 — day 42, dose 4

2022-10-21

Symptoms: Cough, trouble breathing, fatigue

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
SD	Brain fog	·	·	✓
SD	Cough	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Malaise	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Urinary tract infection	✓	✓	✓
SRO	Axillary pain	✓	✓	✓
SRO	Brain fog	·	·	✓
SRO	Chest pain	✓	✓	✓
SRO	Confusional state	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Memory impairment	✓	✓	✓
SRO	Urinary tract infection	✓	✓	✓

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