K45-28931-57915

3 vaccinations 10 coded responses 28 check-ins 10 free-text entries 2 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 114 / NY
Registered: 2021-04-15

Relationship: Self
Race: Multiracial
Ethnicity: Hispanic or Latino

Timeline

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

2021-04-15
Registered in v-safe
2021-04-15
Dose 1 — Moderna
2021-04-15
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-29
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-05-06
Survey response — day 21, dose 1
MedDRA: Fatigue — Feeling: Good · Be unable to do your normal daily activities

Free text: Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Dose 2 — Moderna
2021-05-13
Survey response — day 0, dose 2
MedDRA: Burning sensation, Musculoskeletal stiffness — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Burning sensation in chest lymphatic system, neck stiffness only on side corresponding with injection arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-05-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-05-20
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-27
Survey response — day 14, dose 2
MedDRA: Fatigue, Rectal haemorrhage — Feeling: Fair · Be unable to do your normal daily activities

Free text: Severe fatigue, rectal bleeding

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-06-10
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-06-19
Survey response — day 35, dose 2
MedDRA: Back pain, Dysgeusia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Metallic taste in mouth; back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-24
Survey response — day 42, dose 2
MedDRA: Fatigue, Rectal haemorrhage — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue, rectal bleeding

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-12
Survey response — 3 months, dose 2
MedDRA: Asthenia, Brain fog, Fatigue, Pre-existing disease, Proctitis ulcerative, Sinus congestion — Feeling: Fair · 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

Free text: Symptoms: Fatigue; Weakness; Sinus Congestion; brain fog; Conditions:(worsening) chronic Ulcerative Proctitis

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-12
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-08-20
Call 1 — Left Voicemail
2021-11-13
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-27
Dose 3 — Moderna
2021-12-29
Survey response — day 28, dose 3
MedDRA: Dysphonia, Fatigue, Headache, Oropharyngeal pain, Pain, Rhinorrhoea, Upper-airway cough syndrome — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headache, runny nose, post-nasal drip, sore throat, hoarness, body aches, fatigue,

MedDRA releases: 2024-11 · check-in free text available
2022-01-01
Survey response — day 35, dose 3
MedDRA: Ageusia, Anosmia, Chest pain, Cough, Paranasal sinus discomfort, Sneezing, Throat irritation — Feeling: Poor · Be unable to do your normal daily activities

Free text: Chest pain, sinus pressure, loss of smell and taste, cough, sneezing, scratchy throat

MedDRA releases: 2024-11 · check-in free text available
2022-01-08
Health check-in — day 42, dose 3
Feeling: Poor

Adult check-in
2022-03-01
Survey response — 3 months, dose 3
MedDRA: Brain fog — Feeling: Fair · Be unable to do your normal daily activities

Free text: Brain Fog

MedDRA releases: 2024-11 · check-in free text available
2022-05-28
Survey response — 6 months, dose 3
MedDRA: Dermatitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Dermatitis

MedDRA releases: 2024-11 · check-in free text available
2022-05-28
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-05-31
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-15	Moderna
2	2021-05-13	Moderna
3	2021-11-27	Moderna	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 8 — day 21, dose 1

2021-05-06

Symptoms: Fatigue

Release 8 — day 0, dose 2

2021-05-13

Systemic reaction (other): Burning sensation in chest lymphatic system, neck stiffness only on side corresponding with injection arm

Release 8 — day 14, dose 2

2021-05-27

Symptoms: Severe fatigue, rectal bleeding

Release 9 — day 35, dose 2

2021-06-19

Symptoms: Metallic taste in mouth; back pain

Release 9 — day 42, dose 2

2021-06-24

Symptoms: Fatigue, rectal bleeding

Release 9 — 3 months, dose 2

2021-08-12

Symptoms: Symptoms: Fatigue; Weakness; Sinus Congestion; brain fog; Conditions:(worsening) chronic Ulcerative Proctitis

Release 10 — day 28, dose 3

2021-12-29

Symptoms: Headache, runny nose, post-nasal drip, sore throat, hoarness, body aches, fatigue,

Release 10 — day 35, dose 3

2022-01-01

Symptoms: Chest pain, sinus pressure, loss of smell and taste, cough, sneezing, scratchy throat

Release 11 — 3 months, dose 3

2022-03-01

Symptoms: Brain Fog

Release 11 — 6 months, dose 3

2022-05-28

Symptoms: Dermatitis

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	Ageusia	·	·	✓
SD	Anosmia	·	·	✓
SD	Asthenia	✓	·	✓
SD	Back pain	✓	✓	✓
SD	Brain fog	✓	·	✓
SD	Chest pain	·	·	✓
SD	Cough	·	·	✓
SD	Dermatitis	·	·	✓
SD	Dysgeusia	✓	✓	✓
SD	Dysphonia	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Paranasal sinus discomfort	·	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Proctitis ulcerative	✓	·	✓
SD	Rectal haemorrhage	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	Sinus congestion	✓	·	✓
SD	Sneezing	·	·	✓
SD	Throat irritation	·	·	✓
SD	Upper-airway cough syndrome	·	·	✓
SRO	Burning sensation	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓

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