Z6J-26343-80183

5 vaccinations 7 coded responses 39 check-ins 7 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 535 / WI
Registered: 2021-01-25

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

2021-01-20
Dose 1 — Moderna
2021-01-25
Registered in v-safe
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Chills

Adult check-in
2021-01-27
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-03
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-10
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-17
Dose 2 — Moderna
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-19
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Cough, Erythema — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Coughing, face redness, pain where I had my knee replaced

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: Pain, Redness, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-02-21
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Fair · Site: Pain, Redness · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: I have had lots of coughing every day to point where my chest hurts

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: Chest pain, Cough — Feeling: Fair · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Chronic cough that my chest hurts from coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Vomiting — Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting

Free text: Severe coughing that leads to vomiting at times

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — day 7, dose 2
Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

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

Adult check-in
2021-03-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-18
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-04
Dose 3 — Moderna
2022-02-19
Survey response — 12 months, dose 2
MedDRA: Cough, Exposure to SARS-CoV-2, Headache, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive — Feeling: Fair · Be unable to work or attend school

Free text: Coughing headache runny nose congestion. Tested positive for Covid Thursday. Was directly exposed to others that had Covid.

MedDRA releases: 2024-11 · check-in free text available
2022-04-21
Dose 4 — Moderna
2022-04-30
Health check-in — day 7, dose 4
Feeling: Good · Site: Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-06
Survey response — day 14, dose 4
MedDRA: Sinusitis — Feeling: Fair

Free text: Sinus Infection and currently on antibiotics.

MedDRA releases: 2024-11 · check-in free text available
2022-05-16
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-21
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-27
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-02
Survey response — day 42, dose 4
MedDRA: Dizziness, Headache — Feeling: Fair

Free text: Dizziness and headache

MedDRA releases: 2024-11 · check-in free text available
2022-07-23
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-21
Dose 5 — Moderna
Co-administered: Flu
2022-10-21
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in
2022-10-22
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-23
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-24
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Redness, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-25
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-26
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-30
Health check-in — day 7, dose 5
Feeling: Good · Headache, Fatigue or tiredness

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

Adult check-in
2022-11-18
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-26
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-12-04
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-22
Health check-in — 3 months, dose 5
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-20	Moderna
2	2021-02-17	Moderna
3	2021-11-04	Moderna	No
4	2022-04-21	Moderna	No
5	2022-10-21	Moderna	Flu

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-19

Systemic reaction (other): Coughing, face redness, pain where I had my knee replaced

2021-02-21

Systemic reaction (other): I have had lots of coughing every day to point where my chest hurts

2021-02-22

Systemic reaction (other): Chronic cough that my chest hurts from coughing

2021-02-23

Systemic reaction (other): Severe coughing that leads to vomiting at times

Release 11 — 12 months, dose 2

2022-02-19

Symptoms: Coughing headache runny nose congestion. Tested positive for Covid Thursday. Was directly exposed to others that had Covid.

Release 11 — day 14, dose 4

2022-05-06

Symptoms: Sinus Infection and currently on antibiotics.

Release 11 — day 42, dose 4

2022-06-02

Symptoms: Dizziness and headache

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	Cough	·	·	✓
SD	Dizziness	·	·	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Headache	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Sinusitis	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Vomiting	✓	✓	✓

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