YT4-30289-40442

3 vaccinations 10 coded responses 26 check-ins 10 free-text entries 0 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 838 / ID
Registered: 2021-01-18

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-01-18
Registered in v-safe
2021-01-18
Dose 1 — Moderna
2021-01-18
Survey response — day 0, dose 1
MedDRA: Anxiety — Feeling: Fair · Site: Itching · Fatigue or tiredness

Free text: Anxiety

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-01-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-24
Survey response — days 1–6 daily, dose 1
MedDRA: Depression — Feeling: Good

Free text: Spike in depression last night

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Survey response — day 7, dose 1
MedDRA: Anxiety, Depression — Feeling: Fair · Fatigue or tiredness

Free text: Anxiety/depression

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-08
Survey response — day 21, dose 1
MedDRA: Abdominal pain upper, Flatulence, Pain — Feeling: Fair

Free text: Stress stomach ache today - pain, probably gas but didnt respond to simithacone, uncomfortable to move sometimes, including the movement of breathing. Still worked, just less comfortably.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-16
Dose 2 — Moderna
2021-02-16
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains

Adult check-in
2021-02-17
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia, Nausea — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Trouble sleeping, likely related to nausea last night

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite, Hyposmia, Nasal congestion — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Free text: Decreased appetite, slight increase in nasal congestion with decrease in smell

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal, Memory impairment — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Abdominal pain

Free text: Extra spacey/forgetful at work

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-02-21
Survey response — days 1–6 daily, dose 2
MedDRA: Depression, Pre-existing disease — Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Free text: Increase in depression

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Survey response — days 1–6 daily, dose 2
MedDRA: Depression, Pre-existing disease — Feeling: Fair · Fatigue or tiredness

Free text: Increase depression

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Health check-in — day 7, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-03-02
Survey response — day 14, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good

Free text: I have nausea type GERD that has been less controlled since getting vaccinated, although there are other potential causes like diet variation.

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

Adult check-in
2021-03-16
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-30
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-08-17
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-11-05
Dose 3 — Moderna
2022-02-16
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-08
Health check-in — 6 months, dose 3
Feeling: Poor

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-18	Moderna
2	2021-02-16	Moderna
3	2021-11-05	Moderna	No

Free text

Release 2 — day 0, dose 1

2021-01-18

Systemic reaction (other): Anxiety

Release 2 — days 1–6 daily, dose 1

2021-01-24

Systemic reaction (other): Spike in depression last night

Release 2 — day 7, dose 1

2021-01-25

Systemic reaction (other): Anxiety/depression

Release 3 — day 21, dose 1

2021-02-08

Symptoms: Stress stomach ache today - pain, probably gas but didnt respond to simithacone, uncomfortable to move sometimes, including the movement of breathing. Still worked, just less comfortably.

Release 4 — days 1–6 daily, dose 2

2021-02-17

Systemic reaction (other): Trouble sleeping, likely related to nausea last night

2021-02-18

Systemic reaction (other): Decreased appetite, slight increase in nasal congestion with decrease in smell

2021-02-19

Systemic reaction (other): Extra spacey/forgetful at work

2021-02-21

Systemic reaction (other): Increase in depression

2021-02-22

Systemic reaction (other): Increase depression

Release 4 — day 14, dose 2

2021-03-02

Symptoms: I have nausea type GERD that has been less controlled since getting vaccinated, although there are other potential causes like diet variation.

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	Abdominal pain upper	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Flatulence	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SRO	Anxiety	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Depression	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Hyposmia	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Memory impairment	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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