27A-17216-29145

4 vaccinations 12 coded responses 46 check-ins 12 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 606 / IL
Registered: 2021-03-27

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

2021-03-25
Dose 1 — Moderna
2021-03-27
Registered in v-safe
2021-03-27
Survey response — days 1–6 daily, dose 1
MedDRA: Paraesthesia — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Tingling in arm where I received the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-01
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-08
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-23
Dose 2 — Moderna
2021-04-23
Health check-in — day 0, dose 2
Feeling: Poor · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-24
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Intense itching of the forearm and hand of the injection arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-04-28
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Good

Free text: Itching in foot/ankle on the opposite side of the body from where I was vaccinated.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-08
Survey response — day 14, dose 2
MedDRA: Paraesthesia — Feeling: Good

Free text: Tingling in middle finger of right hand, same side as vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-22
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-28
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-04
Survey response — day 42, dose 2
MedDRA: Depression — Feeling: Fair · Be unable to work

Free text: Depression

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-23
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-10
Dose 3 — Moderna
2021-12-12
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-12-13
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-12-14
Survey response — days 1–6 daily, dose 3
MedDRA: Sleep disorder — Feeling: Good · Fatigue or tiredness

Free text: Sleep disturbance

MedDRA releases: 2024-11 · check-in free text available
2021-12-15
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-12-16
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-17
Health check-in — day 7, dose 3
Feeling: Good · Abdominal pain

Adult check-in
2021-12-24
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-31
Survey response — day 21, dose 3
MedDRA: Diarrhoea, Fatigue, Nausea, Rhinorrhoea, Sinus congestion — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Nausea, diarrhea, fatigue, sinus congestion, runny nose

MedDRA releases: 2024-11 · check-in free text available
2021-12-31
Report sent to call center — day 21, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-05
Call 1 — Could Not Reach Participant
2022-01-07
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-10
Call 2 — Could Not Reach Participant
2022-01-15
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-22
Survey response — day 42, dose 3
MedDRA: Chills, Fatigue, Pain, Rhinorrhoea, Sinus congestion — 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 · Outpatient clinic or urgent care clinic visit

Free text: Chills, runny nose, sinus congestion, body aches, fatigue,

MedDRA releases: 2024-11 · check-in free text available
2022-01-22
Report sent to call center — day 42, 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-24
Call 1 — Could Not Reach Participant
2022-01-27
Call 2 — Could Not Reach Participant
2022-03-11
Survey response — 3 months, dose 3
MedDRA: Brain fog, Fatigue — 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

Free text: Fatigue, brain fog

MedDRA releases: 2024-11 · check-in free text available
2022-03-11
Report sent to call center — 3 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-03-17
Call 1 — Left Voicemail
2022-06-02
Dose 4 — Pfizer-BioNTech
2022-06-03
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-06-04
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-05
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2022-06-07
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2022-06-08
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2022-06-09
Health check-in — day 7, dose 4
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2022-06-16
Survey response — day 14, dose 4
MedDRA: Fatigue — Feeling: Good

Free text: Fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-06-23
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-07-01
Survey response — day 28, dose 4
MedDRA: Fatigue — Feeling: Good

Free text: Fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-07-08
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-14
Survey response — day 42, dose 4
MedDRA: Dizziness — Feeling: Fair

Free text: Light-headed

MedDRA releases: 2024-11 · check-in free text available
2022-12-01
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-06-02
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-25	Moderna
2	2021-04-23	Moderna
3	2021-12-10	Moderna	No
4	2022-06-02	Pfizer-BioNTech	No

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-27

Systemic reaction (other): Tingling in arm where I received the vaccine

Release 7 — days 1–6 daily, dose 2

2021-04-24

Systemic reaction (other): Intense itching of the forearm and hand of the injection arm.

Release 8 — days 1–6 daily, dose 2

2021-04-28

Systemic reaction (other): Itching in foot/ankle on the opposite side of the body from where I was vaccinated.

Release 8 — day 14, dose 2

2021-05-08

Symptoms: Tingling in middle finger of right hand, same side as vaccine

Release 8 — day 42, dose 2

2021-06-04

Symptoms: Depression

Release 10 — days 1–6 daily, dose 3

2021-12-14

Systemic reaction (other): Sleep disturbance

Release 10 — day 21, dose 3

2021-12-31

Symptoms: Nausea, diarrhea, fatigue, sinus congestion, runny nose

Release 11 — day 42, dose 3

2022-01-22

Symptoms: Chills, runny nose, sinus congestion, body aches, fatigue,

Release 11 — 3 months, dose 3

2022-03-11

Symptoms: Fatigue, brain fog

Release 12 — day 14, dose 4

2022-06-16

Symptoms: Fatigue

Release 12 — day 28, dose 4

2022-07-01

Symptoms: Fatigue

Release 12 — day 42, dose 4

2022-07-14

Symptoms: Light-headed

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	Brain fog	·	·	✓
SD	Chills	·	·	✓
SD	Depression	✓	✓	✓
SD	Diarrhoea	·	·	✓
SD	Dizziness	·	·	✓
SD	Fatigue	·	·	✓
SD	Nausea	·	·	✓
SD	Pain	·	·	✓
SD	Paraesthesia	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	Sinus congestion	·	·	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Sleep disorder	·	·	✓

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