YWH-23029-44598

4 vaccinations 10 coded responses 41 check-ins 10 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 851 / AZ
Registered: 2021-05-12

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

2021-04-13
Dose 1 — Moderna
2021-05-11
Dose 2 — Moderna
2021-05-12
Registered in v-safe
2021-05-12
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-05-14
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Good · Headache, Fatigue or tiredness

Free text: It may be because it 100degrees today i

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Sensitivity to weather change — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Tired probably because of heat here in AZ; even walking briefly outside sucks my energy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-18
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-01
Survey response — day 21, dose 2
MedDRA: Fatigue, Headache — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: HeadacheTire easily going upstairs, such that I have to rest to catch breath. Mask on.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-22
Survey response — day 42, dose 2
MedDRA: Pre-existing disease — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Headache - migraine-like, but probably sinus relatedNot uncommon for me, nothing different (frequency, severity, relief) from before/after vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-10
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-09
Dose 3 — Moderna
2021-12-10
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-12
Survey response — days 1–6 daily, dose 3
MedDRA: Sinus congestion — Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Sinus stuffiness

MedDRA releases: 2024-11 · check-in free text available
2021-12-13
Survey response — days 1–6 daily, dose 3
MedDRA: Decreased appetite — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Lack of appetite- unusual for me

MedDRA releases: 2024-11 · check-in free text available
2021-12-14
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-15
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-16
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-23
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-30
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-06
Survey response — day 28, dose 3
MedDRA: Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sinus headache-usually have one when weather changes

MedDRA releases: 2024-11 · check-in free text available
2022-01-13
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-20
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-10
Survey response — 3 months, dose 3
MedDRA: Headache, Sinus congestion — Feeling: Good · Be unable to do your normal daily activities

Free text: Sinus congestion & headache for 48 hours

MedDRA releases: 2024-11 · check-in free text available
2022-04-21
Dose 4 — Moderna
2022-04-22
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · None · Be unable to do your normal daily activities

Adult check-in
2022-04-23
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-04-24
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-25
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-26
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-27
Survey response — days 1–6 daily, dose 4
MedDRA: Anxiety — Feeling: Fair · Be unable to do your normal daily activities

Free text: A feeling of 'foreboding'. Like the painting, The Scream.

MedDRA releases: 2024-11 · check-in free text available
2022-04-28
Survey response — day 7, dose 4
MedDRA: Depressed mood — Feeling: Fair

Free text: Depressed

MedDRA releases: 2024-11 · check-in free text available
2022-05-05
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-12
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-19
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-26
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-02
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-21
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-22
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-21
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-13	Moderna
2	2021-05-11	Moderna
3	2021-12-09	Moderna	No
4	2022-04-21	Moderna	No

Free text

Release 8 — days 1–6 daily, dose 2

2021-05-14

Systemic reaction (other): It may be because it 100degrees today i

2021-05-15

Systemic reaction (other): Tired probably because of heat here in AZ; even walking briefly outside sucks my energy.

Release 8 — day 21, dose 2

2021-06-01

Symptoms: HeadacheTire easily going upstairs, such that I have to rest to catch breath. Mask on.

Release 9 — day 42, dose 2

2021-06-22

Symptoms: Headache - migraine-like, but probably sinus relatedNot uncommon for me, nothing different (frequency, severity, relief) from before/after vaccine.

Release 10 — days 1–6 daily, dose 3

2021-12-12

Systemic reaction (other): Sinus stuffiness

2021-12-13

Systemic reaction (other): Lack of appetite- unusual for me

Release 10 — day 28, dose 3

2022-01-06

Symptoms: Sinus headache-usually have one when weather changes

Release 11 — 3 months, dose 3

2022-03-10

Symptoms: Sinus congestion & headache for 48 hours

Release 11 — days 1–6 daily, dose 4

2022-04-27

Systemic reaction (other): A feeling of 'foreboding'. Like the painting, The Scream.

Release 11 — day 7, dose 4

2022-04-28

Systemic reaction (other): Depressed

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	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Sinus congestion	·	·	✓
SRO	Anxiety	·	·	✓
SRO	Decreased appetite	·	·	✓
SRO	Depressed mood	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Sensitivity to weather change	✓	✓	✓
SRO	Sinus congestion	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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