CCG-15969-80661

5 vaccinations 7 coded responses 61 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 930 / CA
Registered: 2021-01-14

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

Registered dependents

62G-32741-91509 Child or adolescent in my care · Male · 2021-11-05

Timeline

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

2021-01-14
Registered in v-safe
2021-01-14
Dose 1 — Moderna
2021-01-14
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-01-15
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling, Itching · Nausea

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling, Itching · None

Adult check-in
2021-01-21
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-01-28
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-11
Dose 2 — Moderna
2021-02-11
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · None · Be unable to do your normal daily activities

Adult check-in
2021-02-12
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 · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · Headache

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-02-18
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-02-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-12
Survey response — day 28, dose 2
MedDRA: Dizziness, Feeling abnormal — Feeling: Good

Free text: Brain fog and dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — day 35, dose 2
MedDRA: Blood pressure increased, Feeling abnormal — Feeling: Fair

Free text: Raised Blood pressure, Brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-12
Survey response — 6 months, dose 2
MedDRA: Tremor — Feeling: Good

Free text: Arm that was vaccinated will start to shake when I am holding something. Head will slightly shake at times.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-23
Dose 3 — Moderna
2021-10-24
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Itching · Fever · Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-10-30
Health check-in — day 7, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-11-06
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-15
Survey response — day 21, dose 3
MedDRA: Rhinorrhoea, Tremor, Unevaluable event — Feeling: Fair

Free text: Sinus, runny nose. Still continue to have shaking in both arms.

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Survey response — day 28, dose 3
MedDRA: Brain fog — Feeling: Fair

Free text: Brain fog

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-04
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-22
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-04
Dose 4 — Moderna
2022-04-04
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-04-05
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 · Be unable to do your normal daily activities

Adult check-in
2022-04-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-04-07
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2022-04-08
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2022-04-09
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-04-11
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-04-18
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-25
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-04
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-09
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-16
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-06
Survey response — 3 months, dose 4
MedDRA: COVID-19 — Feeling: Fair · Be unable to work or attend school

Free text: Covid

MedDRA releases: 2024-11 · check-in free text available
2022-09-22
Dose 5 — Moderna
Co-administered: Flu
2022-09-22
Health check-in — day 0, dose 5
Feeling: Fair · Site: Pain · None

Adult check-in
2022-09-24
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2022-09-25
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-09-26
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-09-27
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-09-28
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-09-29
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-10-06
Survey response — day 14, dose 5
MedDRA: Initial insomnia — Feeling: Fair

Free text: Am not able to fall asleep

MedDRA releases: 2024-11 · check-in free text available
2022-10-13
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-29
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-12-22
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-23
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-14	Moderna
2	2021-02-11	Moderna
3	2021-10-23	Moderna	No
4	2022-04-04	Moderna	No
5	2022-09-22	Moderna	Flu

Call center

1 call center case

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

See the call center timeline

Free text

Release 5 — day 28, dose 2

2021-03-12

Symptoms: Brain fog and dizziness

Release 5 — day 35, dose 2

2021-03-18

Symptoms: Raised Blood pressure, Brain fog

Release 9 — 6 months, dose 2

2021-08-12

Symptoms: Arm that was vaccinated will start to shake when I am holding something. Head will slightly shake at times.

Release 10 — day 21, dose 3

2021-11-15

Symptoms: Sinus, runny nose. Still continue to have shaking in both arms.

Release 10 — day 28, dose 3

2021-11-20

Symptoms: Brain fog

Release 12 — 3 months, dose 4

2022-07-06

Symptoms: Covid

Release 12 — day 14, dose 5

2022-10-06

Symptoms: Am not able to fall asleep

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	Blood pressure increased	✓	✓	✓
SD	Brain fog	·	·	✓
SD	COVID-19	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Initial insomnia	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Tremor	✓	·	✓
SD	Unevaluable event	·	·	✓

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