ZXU-15729-64837

5 vaccinations 24 coded responses 65 check-ins 22 free-text entries 11 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 919 / CA
Registered: 2021-02-24

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

Timeline

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

2021-02-24
Registered in v-safe
2021-02-24
Dose 1 — Moderna
2021-02-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Nausea

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Nausea

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Nausea

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-03
Health check-in — day 7, dose 1
Feeling: Good · Nausea

Adult check-in
2021-03-10
Survey response — day 14, dose 1
MedDRA: Hyperhidrosis — Feeling: Good

Free text: Woke up on day 14 after vaccination dripping in sweat what i never experienced befor.Measured in the morning temperature, it was normal.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-24
Dose 2 — Moderna
2021-03-24
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Diarrhea · Be unable to work

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Diarrhea

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling, Itching · None

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · None

Adult check-in
2021-03-29
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site bruising — Feeling: Good · Site: Pain, Itching

Free text: Blue bruise on injection spot!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-31
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-07
Survey response — day 14, dose 2
MedDRA: Haemorrhage, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Blood spotting from either bladder or vaginally one night!Don't know if that has anything to do with it.That is the first time.Any questions on that please call. (b)(6) · Healthcare visit (other): Had an appointment anyway with my Cardiologist, also M.D.Had some tests done,and still waiting for a few more!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-14
Survey response — day 21, dose 2
MedDRA: Vertigo, Vomiting — Feeling: Poor · Be unable to do your normal daily activities

Free text: In the morning and still over the day today,vertigo and throwing up.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — day 28, dose 2
MedDRA: Balance disorder, Dizziness — Feeling: Fair

Free text: Still somewhat light headed and off-balance !

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-05
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-23
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-22
Survey response — 6 months, dose 2
MedDRA: Arthralgia, Emergency care, Vertigo — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Vertigo,brought me to hospital end of july.Increase of joint pain.

MedDRA releases: 2024-11 · check-in free text available
2021-09-22
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-09-24
Call 2 — Left Voicemail
2021-11-03
Dose 3 — Moderna
2021-11-04
Survey response — days 1–6 daily, dose 3
MedDRA: Immediate post-injection reaction, Throat irritation — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness · Be unable to work or attend school

Free text: About 2 to 5 min after injection i had a burning in the back off my throught what went away after a few hours

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Fever · Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-11-06
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Joint pains

Adult check-in
2021-11-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling · Joint pains, Fatigue or tiredness

Adult check-in
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains

Adult check-in
2021-11-10
Health check-in — day 7, dose 3
Feeling: Good · Joint pains

Adult check-in
2021-11-17
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-24
Survey response — day 21, dose 3
MedDRA: Head discomfort — Feeling: Good

Free text: Mild discomfort about 3 inches left above forhead!

MedDRA releases: 2024-11 · check-in free text available
2021-12-01
Survey response — day 28, dose 3
MedDRA: Arthralgia — Feeling: Good

Free text: Joint pain in knees and elbow!

MedDRA releases: 2024-11 · check-in free text available
2021-12-08
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-15
Survey response — day 42, dose 3
MedDRA: Blood pressure increased, Headache, Medical counselling, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Don't know if it has anything to do with it.pressure headache. Blood pressure 185,176,154,138,126,113,120,for a few days.now down in normal range. Called my cardiologist,he took c a re of me with increase of meds. · Healthcare visit (other): My Cardiologist!

MedDRA releases: 2024-11 · check-in free text available
2021-12-15
Report sent to call center — day 42, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-16
Call successful
Not applicable - Accidental Reporting
2022-02-02
Survey response — 3 months, dose 3
MedDRA: Back pain, Cough, Dyspnoea, Ear discomfort, Head discomfort, Office visit, Rhinorrhoea, SARS-CoV-2 test negative, SARS-CoV-2 test positive, Sneezing — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Tested positive for Covid on january 24.Retestedon February 1 negative. Symptoms: sneezing,runny nose, Shortness of breath,heavy pressure in hole head incl.ears,dry cough,upper too lower back pain, · Healthcare visit (other): Went to my Cardiologists on 2-2-2022

MedDRA releases: 2024-11 · check-in free text available
2022-02-02
Report sent to call center — 3 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-02-03
Call successful
Not applicable - Accidental Reporting
2022-05-11
Dose 4 — Moderna
2022-05-11
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2022-05-11
Survey response — 6 months, dose 3
MedDRA: Cough, Discomfort, Dyspnoea, Ear discomfort, Ear pain, Nasopharyngitis, Office visit, Pain in jaw, SARS-CoV-2 test positive — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Tested positive for covid on January 24.Sence i have ,Shortness of breath. Persistent dry cough. Pressure and pain in ear/jawbone area. In addition i contracted a bad cold beginning of April and still lingers around hat i didn't had for many years. · Healthcare visit (other): Primary Physician

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-05-12
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Fever · Headache

Adult check-in
2022-05-12
Call successful
Not applicable - Accidental Reporting
2022-05-12
Call successful
Not applicable - Accidental Reporting
2022-05-12
Call successful
Not applicable - Accidental Reporting
2022-05-13
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Headache

Adult check-in
2022-05-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2022-05-15
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2022-05-18
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-25
Survey response — day 14, dose 4
MedDRA: Fatigue, Pain — Feeling: Fair

Free text: Body aches, getting and feeling tired easy,

MedDRA releases: 2024-11 · check-in free text available
2022-06-01
Survey response — day 21, dose 4
MedDRA: Blood pressure fluctuation, Feeling jittery, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: BLOOD PRESSURE IS UP AND DOWN. FEELING JITTERS. · Healthcare visit (other): Primary Doctor.

MedDRA releases: 2024-11 · check-in free text available
2022-06-01
Report sent to call center — day 21, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-06-02
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-08
Survey response — day 28, dose 4
MedDRA: Blood pressure fluctuation, Chest discomfort, Tremor — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Blood pressure is going up and down! Chest pressure. Shaking.

MedDRA releases: 2024-11 · check-in free text available
2022-06-08
Report sent to call center — day 28, dose 4
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-06-09
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-15
Survey response — day 35, dose 4
MedDRA: Blood pressure increased, Dizziness, Hospitalisation, Nausea — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Got admitted to hospital on june 6th. With BP 189/77/90 Feeling lightheaded and nauseous. Had Angiogram and Endoscopy,results for Angiogram no blockage! For Endoscopy unavailable right now,since done on june 9. Still dizziness and nauseous!

MedDRA releases: 2024-11 · check-in free text available
2022-06-15
Report sent to call center — day 35, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-06-16
Call 1 — Left Voicemail
2022-06-16
Call 1 — Left Voicemail
2022-06-16
Call 1 — Left Voicemail
2022-06-16
Call 1 — Left Voicemail
2022-06-16
Call 1 — Left Voicemail
2022-06-16
Call 1 — Left Voicemail
2022-06-16
Call 1 — Left Voicemail
2022-06-16
Call 1 — Left Voicemail
2022-06-22
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-08-10
Survey response — 3 months, dose 4
MedDRA: Unevaluable event — Feeling: Good

Free text: I

MedDRA releases: 2024-11 · check-in free text available
2022-11-09
Survey response — 6 months, dose 4
MedDRA: COVID-19, Cough, Dyspnoea, Office visit — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: Cough in April for a few weeks. Cough in from September until now. Stil lshort of breath after January's Covid · Healthcare visit (other): Primary

MedDRA releases: 2024-11 · check-in free text available
2022-11-09
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-11-10
Call 2 — Left Voicemail
2022-11-10
Call 1 — Left Voicemail
2022-11-30
Dose 5 — Moderna
2022-11-30
Health check-in — day 0, dose 5
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2022-12-01
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · None

Adult check-in
2022-12-02
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · Diarrhea

Adult check-in
2022-12-03
Survey response — days 1–6 daily, dose 5
MedDRA: Muscle spasms — Feeling: Good · Site: Pain, Swelling

Free text: Cramps in left calf for 2 mornings!

MedDRA releases: 2024-11 · check-in free text available
2022-12-04
Survey response — days 1–6 daily, dose 5
MedDRA: Blood pressure increased — Feeling: Fair · Site: Pain, Swelling, Itching · Nausea, Diarrhea

Free text: Blood pressure up

MedDRA releases: 2024-11 · check-in free text available
2022-12-05
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2022-12-06
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-12-07
Health check-in — day 7, dose 5
Feeling: Fair · Headache, Nausea

Adult check-in
2022-12-14
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-12-21
Survey response — day 21, dose 5
MedDRA: Arthralgia, Dizziness, Nausea — Feeling: Fair

Free text: Lightheaded,nauseous,pain in shoulder where shot was given!

MedDRA releases: 2024-11 · check-in free text available
2022-12-28
Survey response — day 28, dose 5
MedDRA: Blood pressure abnormal, Dizziness, Office visit, Restlessness — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Blood pressure not stable. Lightheaded. Restless! · Healthcare visit (other): Regular physician!

MedDRA releases: 2024-11 · check-in free text available
2022-12-28
Report sent to call center — day 28, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2022-12-29
Call successful
Not applicable - Accidental Reporting
2022-12-29
Call successful
Not applicable - Accidental Reporting
2022-12-29
Call successful
Not applicable - Accidental Reporting
2023-01-04
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2023-01-11
Survey response — day 42, dose 5
MedDRA: Blood pressure fluctuation, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-01-11
Report sent to call center — day 42, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2023-01-12
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-01
Survey response — 3 months, dose 5
MedDRA: COVID-19 — Feeling: Poor · Be unable to work or attend school

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-24	Moderna
2	2021-03-24	Moderna
3	2021-11-03	Moderna	No
4	2022-05-11	Moderna	No
5	2022-11-30	Moderna	No

Call center

11 call center cases

11 successful

3 waits over 3 months for a first call

See the call center timeline

Free text

Release 5 — day 14, dose 1

2021-03-10

Symptoms: Woke up on day 14 after vaccination dripping in sweat what i never experienced befor.Measured in the morning temperature, it was normal.

Release 6 — days 1–6 daily, dose 2

2021-03-29

Systemic reaction (other): Blue bruise on injection spot!

Release 7 — day 14, dose 2

2021-04-07

Symptoms: Blood spotting from either bladder or vaginally one night!Don't know if that has anything to do with it.That is the first time.Any questions on that please call. (b)(6)

Healthcare visit (other): Had an appointment anyway with my Cardiologist, also M.D.Had some tests done,and still waiting for a few more!

redacted (b)(6)

Release 7 — day 21, dose 2

2021-04-14

Symptoms: In the morning and still over the day today,vertigo and throwing up.

Release 7 — day 28, dose 2

2021-04-21

Symptoms: Still somewhat light headed and off-balance !

Release 9 — 6 months, dose 2

2021-09-22

Symptoms: Vertigo,brought me to hospital end of july.Increase of joint pain.

Release 10 — days 1–6 daily, dose 3

2021-11-04

Systemic reaction (other): About 2 to 5 min after injection i had a burning in the back off my throught what went away after a few hours

Release 10 — day 21, dose 3

2021-11-24

Symptoms: Mild discomfort about 3 inches left above forhead!

Release 10 — day 28, dose 3

2021-12-01

Symptoms: Joint pain in knees and elbow!

Release 10 — day 42, dose 3

2021-12-15

Symptoms: Don't know if it has anything to do with it.pressure headache. Blood pressure 185,176,154,138,126,113,120,for a few days.now down in normal range. Called my cardiologist,he took c a re of me with increase of meds.

Healthcare visit (other): My Cardiologist!

Release 11 — 3 months, dose 3

2022-02-02

Symptoms: Tested positive for Covid on january 24.Retestedon February 1 negative. Symptoms: sneezing,runny nose, Shortness of breath,heavy pressure in hole head incl.ears,dry cough,upper too lower back pain,

Healthcare visit (other): Went to my Cardiologists on 2-2-2022

Release 11 — 6 months, dose 3

2022-05-11

Symptoms: Tested positive for covid on January 24.Sence i have ,Shortness of breath. Persistent dry cough. Pressure and pain in ear/jawbone area. In addition i contracted a bad cold beginning of April and still lingers around hat i didn't had for many years. cut off by CDC

Healthcare visit (other): Primary Physician

Release 11 — day 14, dose 4

2022-05-25

Symptoms: Body aches, getting and feeling tired easy,

Release 11 — day 21, dose 4

2022-06-01

Symptoms: BLOOD PRESSURE IS UP AND DOWN. FEELING JITTERS.

Healthcare visit (other): Primary Doctor.

Release 11 — day 28, dose 4

2022-06-08

Symptoms: Blood pressure is going up and down! Chest pressure. Shaking.

Release 12 — day 35, dose 4

2022-06-15

Symptoms: Got admitted to hospital on june 6th. With BP 189/77/90 Feeling lightheaded and nauseous. Had Angiogram and Endoscopy,results for Angiogram no blockage! For Endoscopy unavailable right now,since done on june 9. Still dizziness and nauseous!

Release 12 — 3 months, dose 4

2022-08-10

Symptoms: I

Release 12 — 6 months, dose 4

2022-11-09

Symptoms: Cough in April for a few weeks. Cough in from September until now. Stil lshort of breath after January's Covid

Healthcare visit (other): Primary

Release 12 — days 1–6 daily, dose 5

2022-12-03

Systemic reaction (other): Cramps in left calf for 2 mornings!

2022-12-04

Systemic reaction (other): Blood pressure up

Release 12 — day 21, dose 5

2022-12-21

Symptoms: Lightheaded,nauseous,pain in shoulder where shot was given!

Release 12 — day 28, dose 5

2022-12-28

Symptoms: Blood pressure not stable. Lightheaded. Restless!

Healthcare visit (other): Regular physician!

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	✓	✓	✓
SD	Arthralgia	·	·	✓
SD	Back pain	·	·	✓
SD	Balance disorder	✓	✓	✓
SD	Blood pressure abnormal	·	·	✓
SD	Blood pressure fluctuation	·	·	✓
SD	Blood pressure increased	·	·	✓
SD	Chest discomfort	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Discomfort	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	·	·	✓
SD	Ear discomfort	·	·	✓
SD	Ear pain	·	·	✓
SD	Emergency care	·	·	✓
SD	Fatigue	·	·	✓
SD	Feeling jittery	·	·	✓
SD	Haemorrhage	✓	✓	✓
SD	Head discomfort	·	·	✓
SD	Headache	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Hyperhidrosis	✓	✓	✓
SD	Medical counselling	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Nausea	·	·	✓
SD	Pain	·	·	✓
SD	Pain in jaw	·	·	✓
SD	Restlessness	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Sneezing	·	·	✓
SD	Tremor	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Vertigo	✓	✓	✓
SD	Vomiting	✓	✓	✓
SRO	Blood pressure increased	·	·	✓
SRO	Immediate post-injection reaction	·	·	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Muscle spasms	·	·	✓
SRO	Throat irritation	·	·	✓

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