ZZ8-17239-87639

2 vaccinations 8 coded responses 24 check-ins 8 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 207 / MD
Registered: 2021-05-03

Relationship: Self
Race: Other
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

2021-05-03
Registered in v-safe
2021-05-03
Dose 1 — Moderna
2021-05-03
Survey response — day 0, dose 1
MedDRA: Pyrexia — Feeling: Good · Fever · Chills, Headache

Free text: Brief feverish feeling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-05-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-05-08
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Good · Chills

Free text: Slight dizziness this morning.

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

Adult check-in
2021-05-10
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-05-17
Survey response — day 14, dose 1
MedDRA: Fatigue — Feeling: Good

Free text: I've been a bit tired where I normally would be more energetic.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-06-01
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-06-06
Dose 2 — Moderna
2021-06-07
Survey response — days 1–6 daily, dose 2
MedDRA: Breast pain, Injection site pain — Feeling: Fair · Site: Pain, Swelling · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sharp piercing pain that ran from the injection site down through my left breast that only lasted about ten minutes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-06-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-06-10
Survey response — days 1–6 daily, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Having bouts of forgetfulness more now then before the injection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-06-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-06-13
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-06-20
Survey response — day 14, dose 2
MedDRA: Memory impairment — Feeling: Good

Free text: I'm still suffering with forgetfulness more now than before the injection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-27
Survey response — day 21, dose 2
MedDRA: Memory impairment — Feeling: Good

Free text: I'm still suffering with forgetfulness, especially short term memory that was not apparent before my last injection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-07-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-07-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-09-05
Survey response — 3 months, dose 2
MedDRA: Asthenia, Dizziness, Pyrexia — Feeling: Good · Be unable to work or attend school

Free text: Two weeks ago, about August 26, I experienced a feeling of extreme dizziness, fever so great that I looked like I had just gotten out of a pool, and extreme weakness. My daughter, thank God, was with me to witness it a nd she brought me cold water.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-12-05
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-03	Moderna
2	2021-06-06	Moderna

Free text

Release 8 — day 0, dose 1

2021-05-03

Systemic reaction (other): Brief feverish feeling

Release 8 — days 1–6 daily, dose 1

2021-05-08

Systemic reaction (other): Slight dizziness this morning.

Release 8 — day 14, dose 1

2021-05-17

Symptoms: I've been a bit tired where I normally would be more energetic.

Release 8 — days 1–6 daily, dose 2

2021-06-07

Systemic reaction (other): Sharp piercing pain that ran from the injection site down through my left breast that only lasted about ten minutes.

Release 9 — days 1–6 daily, dose 2

2021-06-10

Systemic reaction (other): Having bouts of forgetfulness more now then before the injection.

Release 9 — day 14, dose 2

2021-06-20

Symptoms: I'm still suffering with forgetfulness more now than before the injection.

Release 9 — day 21, dose 2

2021-06-27

Symptoms: I'm still suffering with forgetfulness, especially short term memory that was not apparent before my last injection.

Release 9 — 3 months, dose 2

2021-09-05

Symptoms: Two weeks ago, about August 26, I experienced a feeling of extreme dizziness, fever so great that I looked like I had just gotten out of a pool, and extreme weakness. My daughter, thank God, was with me to witness it a nd she brought me cold water. cut off by CDC

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	Asthenia	✓	·	✓
SD	Dizziness	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Memory impairment	✓	✓	✓
SD	Pyrexia	✓	·	✓
SRO	Breast pain	·	·	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pyrexia	✓	✓	✓

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