277-30903-28762

4 vaccinations 9 coded responses 27 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 980 / WA
Registered: 2021-03-19

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

Timeline

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

2021-03-17
Dose 1 — Moderna
2021-03-19
Registered in v-safe
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · Fatigue or tiredness

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-03-24
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-31
Survey response — day 14, dose 1
MedDRA: Myasthenia gravis, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

Free text: Exacerbation of previously diagnosed myasthenia gravis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — day 21, dose 1
MedDRA: Eyelid ptosis, Myasthenia gravis — Feeling: Good

Free text: Myasthenia Gravis symptoms worsened, more ptosis and need for Pyridostigmine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Dose 2 — Moderna
2021-04-14
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease — Feeling: Poor · Site: Pain, Swelling · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Mild exacerbation of Myasthenia Gravis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Condition aggravated, Diplopia, Pre-existing disease — Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Mild exacerbation of myasthenia gravis with double vision and worsening ptosis.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-28
Survey response — day 14, dose 2
MedDRA: Myasthenia gravis, Pre-existing disease — Feeling: Good

Free text: Exacerbation of Myasthenia Gravis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Survey response — day 21, dose 2
MedDRA: Herpes zoster — Feeling: Poor · Be unable to do your normal daily activities

Free text: Reoccurrence of shingles ( also got them after 1st dose. I am immune suppressed and have chronic shingles)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-19
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-26
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-14
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-29
Dose 3 — Moderna
2021-10-13
Survey response — 6 months, dose 2
MedDRA: Paraesthesia, Paraesthesia oral — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Tingling in hands and face/lips

MedDRA releases: 2024-11 · check-in free text available
2021-10-13
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-18
Call 1 — Left Voicemail
2021-11-28
Survey response — 3 months, dose 3
MedDRA: Rash — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Rash across face

MedDRA releases: 2024-11 · check-in free text available
2021-11-28
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-30
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-02-28
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-03-09
Dose 4 — Moderna
2022-04-20
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-06-08
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-09-09
Health check-in — 6 months, dose 4
Feeling: Poor

Adult check-in
2023-03-09
Survey response — 12 months, dose 4
MedDRA: Oral blood blister, Oral mucosal eruption, Rash — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-03-09
Report sent to call center — 12 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-03-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-17	Moderna
2	2021-04-14	Moderna
3	2021-08-29	Moderna	No
4	2022-03-09	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 6 — day 14, dose 1

2021-03-31

Symptoms: Exacerbation of previously diagnosed myasthenia gravis

Release 7 — day 21, dose 1

2021-04-07

Symptoms: Myasthenia Gravis symptoms worsened, more ptosis and need for Pyridostigmine

Release 7 — days 1–6 daily, dose 2

2021-04-15

Systemic reaction (other): Mild exacerbation of Myasthenia Gravis

2021-04-16

Systemic reaction (other): Mild exacerbation of myasthenia gravis with double vision and worsening ptosis.

Release 8 — day 14, dose 2

2021-04-28

Symptoms: Exacerbation of Myasthenia Gravis

Release 8 — day 21, dose 2

2021-05-05

Symptoms: Reoccurrence of shingles ( also got them after 1st dose. I am immune suppressed and have chronic shingles)

Release 10 — 6 months, dose 2

2021-10-13

Symptoms: Tingling in hands and face/lips

Release 10 — 3 months, dose 3

2021-11-28

Symptoms: Rash across face

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	Eyelid ptosis	✓	✓	✓
SD	Herpes zoster	✓	✓	✓
SD	Myasthenia gravis	✓	✓	✓
SD	Oral blood blister	·	·	✓
SD	Oral mucosal eruption	·	·	✓
SD	Paraesthesia	·	·	✓
SD	Paraesthesia oral	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rash	·	·	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Diplopia	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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