PMG-22387-94270

5 vaccinations 11 coded responses 38 check-ins 11 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 018 / MA
Registered: 2021-01-31

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

Registered dependents

3GC-93842-51585 Child or adolescent in my care · Female · 2022-07-22

Timeline

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

2021-01-30
Dose 1 — Moderna
2021-01-31
Registered in v-safe
2021-01-31
Survey response — days 1–6 daily, dose 1
MedDRA: Chills, Feeling cold, Tremor — Feeling: Fair · Site: Pain · Chills, Headache · Be unable to work, Be unable to do your normal daily activities

Free text: Extremely cold & Shaking along with chills

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Diarrhea · Be unable to work

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-02-06
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-13
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-20
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-27
Dose 2 — Moderna
2021-02-27
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Urinary tract infection — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: UTI

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Urinary tract infection — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness, Diarrhea · Be unable to work

Free text: UTI

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — day 7, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · Diarrhea

Adult check-in
2021-03-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-31
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-28
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-12
Dose 3 — Moderna
2022-01-23
Call 1 — Left Voicemail
2022-02-27
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-07-08
Dose 4 — Moderna
2022-11-04
Dose 5 — Moderna
2022-11-04
Survey response — day 0, dose 5
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-11-06
Survey response — days 1–6 daily, dose 5
MedDRA: No adverse event — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-11-07
Survey response — days 1–6 daily, dose 5
MedDRA: No adverse event — Feeling: Good · Site: Pain

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-11-08
Survey response — days 1–6 daily, dose 5
MedDRA: No adverse event — Feeling: Good · Site: Pain · Headache

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-11-09
Survey response — days 1–6 daily, dose 5
MedDRA: No adverse event — Feeling: Good · Site: Pain

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-11-10
Survey response — days 1–6 daily, dose 5
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-11-11
Survey response — day 7, dose 5
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-11-18
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-11-25
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-12-02
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-12-10
Survey response — day 35, dose 5
MedDRA: Diarrhoea, Nausea — Feeling: Good · Be unable to do your normal daily activities

Free text: Diarrhea and nausea

MedDRA releases: 2024-11 · check-in free text available
2022-12-18
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-02-05
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-05-06
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-30	Moderna
2	2021-02-27	Moderna
3	2021-11-12	Moderna	No
4	2022-07-08	Moderna	No
5	2022-11-04	Moderna	No

Call center

1 call center case

1 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-31

Systemic reaction (other): Extremely cold & Shaking along with chills

Release 5 — days 1–6 daily, dose 2

2021-03-04

Systemic reaction (other): UTI

2021-03-05

Systemic reaction (other): UTI

Release 12 — day 0, dose 5

2022-11-04

Systemic reaction (other): No

Release 12 — days 1–6 daily, dose 5

2022-11-06

Systemic reaction (other): No

2022-11-07

Systemic reaction (other): No

2022-11-08

Systemic reaction (other): No

2022-11-09

Systemic reaction (other): No

2022-11-10

Systemic reaction (other): No

Release 12 — day 7, dose 5

2022-11-11

Systemic reaction (other): No

Release 12 — day 35, dose 5

2022-12-10

Symptoms: Diarrhea and nausea

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	Diarrhoea	·	·	✓
SD	Nausea	·	·	✓
SRO	Chills	✓	✓	✓
SRO	Feeling cold	✓	✓	✓
SRO	No adverse event	·	·	✓
SRO	Tremor	✓	✓	✓
SRO	Urinary tract infection	✓	✓	✓

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