22D-16275-53387

4 vaccinations 5 coded responses 38 check-ins 5 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 983 / WA
Registered: 2021-03-11

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

2021-02-11
Dose 1 — Moderna
2021-03-11
Registered in v-safe
2021-03-11
Survey response — day 28, dose 1
MedDRA: Pain in extremity, Paraesthesia, Rash, Rash erythematous, Skin warm — Feeling: Good

Free text: My arm developed a rectangular red rash, very warm and tingling on day 10 folliwing dose 1. Then occurred again on day 15. It is still sore off and on. No fever. Was made worse after a shower!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Dose 2 — Moderna
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema, Injection site pruritus, Injection site warmth, Pain in extremity — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Arm very sore, red, itchy and hot below the injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-21
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-02
Survey response — day 21, dose 2
MedDRA: Fatigue, Malaise — Feeling: Good

Free text: Just very tired. I am sleeping fine, but am so tired during the day. It's like hitting a brick wall, I'm done! Been that way now for 3 days.

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

Adult check-in
2021-04-18
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-10
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-23
Dose 3 — Moderna
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling, Itching · Fever · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Chills, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Chills, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-10-30
Health check-in — day 7, dose 3
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-11-06
Survey response — day 14, dose 3
MedDRA: Diarrhoea, Pyrexia, Toothache — Feeling: Fair · Be unable to do your normal daily activities

Free text: I doubt related to booster, but have a toothache, low grade fever and diarrhea.

MedDRA releases: 2024-11 · check-in free text available
2021-11-13
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-20
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-27
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-01-22
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-23
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-18
Dose 4 — Moderna
2022-05-19
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site

Adult check-in
2022-05-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Redness, Swelling · Rash, not including the immediate area around the injection site

Adult check-in
2022-05-21
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Itching · Fever · Muscle or body aches, Abdominal pain, Rash, not including the immediate area around the injection site

Adult check-in
2022-05-22
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Redness, Swelling · Muscle or body aches, Rash, not including the immediate area around the injection site

Adult check-in
2022-05-25
Health check-in — day 7, dose 4
Feeling: Good · Site: Redness, Itching · Rash, not including the immediate area around the injection site

Adult check-in
2022-06-01
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-08
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-15
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-22
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-29
Survey response — day 42, dose 4
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Extremely tired. Some days i am barely able to put one foot in front of the other.

MedDRA releases: 2024-11 · check-in free text available
2022-08-17
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-16
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-05-18
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-11	Moderna
2	2021-03-12	Moderna
3	2021-10-23	Moderna	No
4	2022-05-18	Moderna	No

Free text

Release 5 — day 28, dose 1

2021-03-11

Symptoms: My arm developed a rectangular red rash, very warm and tingling on day 10 folliwing dose 1. Then occurred again on day 15. It is still sore off and on. No fever. Was made worse after a shower!

Release 5 — days 1–6 daily, dose 2

2021-03-13

Systemic reaction (other): Arm very sore, red, itchy and hot below the injection site.

Release 6 — day 21, dose 2

2021-04-02

Symptoms: Just very tired. I am sleeping fine, but am so tired during the day. It's like hitting a brick wall, I'm done! Been that way now for 3 days.

Release 10 — day 14, dose 3

2021-11-06

Symptoms: I doubt related to booster, but have a toothache, low grade fever and diarrhea.

Release 12 — day 42, dose 4

2022-06-29

Symptoms: Extremely tired. Some days i am barely able to put one foot in front of the other.

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	Diarrhoea	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Paraesthesia	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Rash	✓	✓	✓
SD	Rash erythematous	✓	✓	✓
SD	Skin warm	✓	✓	✓
SD	Toothache	·	·	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	Injection site warmth	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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