QCN-30821-93629

4 vaccinations 9 coded responses 45 check-ins 8 free-text entries 4 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 958 / CA
Registered: 2021-03-07

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

Registered dependents

4N3-28371-18257 Child or adolescent in my care · Female · 2021-11-14

W2K-19503-91610 Child or adolescent in my care · Female · 2021-11-14

TAF-14391-95391 Child or adolescent in my care · Female · 2021-11-14

Timeline

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

2021-02-23
Dose 1 — Moderna
2021-03-07
Registered in v-safe
2021-03-07
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-09
Survey response — day 14, dose 1
MedDRA: Headache — Feeling: Fair

Free text: Headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — day 21, dose 1
MedDRA: Fatigue, Headache, Intermenstrual bleeding, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Most likely not at all related, but fatigue, headache and breakthrough menstrual bleeding. · Healthcare visit (other): In-person doctor appointment scheduled for Monday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-23
Dose 2 — Moderna
2021-03-23
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-30
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-06
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-13
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-27
Survey response — day 35, dose 2
MedDRA: Fatigue — Feeling: Fair

Free text: Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-22
Survey response — 3 months, dose 2
MedDRA: Diarrhoea, Headache, Pyrexia — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Fever, headache, diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-22
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-29
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-09-21
Survey response — 6 months, dose 2
MedDRA: Anxiety — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Anxiety

MedDRA releases: 2024-11 · check-in free text available
2021-09-21
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-22
Call 2 — Left Voicemail
2021-10-25
Dose 3 — Moderna
2021-10-25
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain · None

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

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

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

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

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Good · Nausea

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-29
Survey response — day 35, dose 3
MedDRA: Oropharyngeal pain, Rhinorrhoea — Feeling: Good

Free text: Sore throat, runny nose

MedDRA releases: 2024-11 · check-in free text available
2021-12-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-24
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-25
Survey response — 6 months, dose 3
MedDRA: COVID-19 — Feeling: Fair · Be unable to do your normal daily activities

Free text: Covid positive

MedDRA releases: 2024-11 · check-in free text available
2022-11-01
Survey response — 12 months, dose 3
MedDRA: Dry eye, Eye pain — Feeling: Fair

Free text: Sore, dry eyes

MedDRA releases: 2024-11 · check-in free text available
2022-11-11
Dose 4 — Moderna
2022-11-12
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Swelling · 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
2022-11-13
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-11-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-11-16
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-11-18
Health check-in — day 7, dose 4
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-11-26
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-12-04
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-12-11
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-12-16
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-12-24
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-02-10
Survey response — 3 months, dose 4
MedDRA: Cough, Nasopharyngitis, Physiotherapy — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-02-10
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2023-02-13
Call 1 — Left Voicemail
2023-02-13
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-23	Moderna
2	2021-03-23	Moderna
3	2021-10-25	Moderna	No
4	2022-11-11	Moderna	No

Call center

4 call center cases

2 successful · 2 unsuccessful

See the call center timeline

Free text

Release 5 — day 14, dose 1

2021-03-09

Symptoms: Headache

Release 5 — day 21, dose 1

2021-03-18

Symptoms: Most likely not at all related, but fatigue, headache and breakthrough menstrual bleeding.

Healthcare visit (other): In-person doctor appointment scheduled for Monday

Release 8 — day 35, dose 2

2021-04-27

Symptoms: Fatigue

Release 9 — 3 months, dose 2

2021-06-22

Symptoms: Fever, headache, diarrhea

Release 9 — 6 months, dose 2

2021-09-21

Symptoms: Anxiety

Release 10 — day 35, dose 3

2021-11-29

Symptoms: Sore throat, runny nose

Release 11 — 6 months, dose 3

2022-04-25

Symptoms: Covid positive

Release 12 — 12 months, dose 3

2022-11-01

Symptoms: Sore, dry eyes

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	Office visit	✓	✓	✓
HCVO	Physiotherapy	·	·	✓
SD	Anxiety	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dry eye	·	·	✓
SD	Eye pain	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Intermenstrual bleeding	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	Rhinorrhoea	·	·	✓

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