282-21807-71781

3 vaccinations 7 coded responses 33 check-ins 7 free-text entries 0 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 454 / OH
Registered: 2021-03-23

Relationship: Self
Race: Black or African American
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

2021-03-20
Dose 1 — Moderna
2021-03-23
Registered in v-safe
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-24
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary pain, Injection site pain, Oedema peripheral, Rash — Feeling: Fair · Site: Pain, Redness, Swelling · Nausea · Be unable to do your normal daily activities

Free text: When I got the shot it hurt 4 days I have a rash under my arm it swelling up and hurt

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Swelling · Fatigue or tiredness, Nausea

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-03-27
Health check-in — day 7, dose 1
Feeling: Fair · Site: Swelling · Fatigue or tiredness

Adult check-in
2021-04-03
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-17
Dose 2 — Moderna
2021-04-17
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-18
Survey response — days 1–6 daily, dose 2
MedDRA: Lacrimation increased — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: My left eye keep watering up . On the same side I got my shit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches

Adult check-in
2021-04-20
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Lacrimation increased — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: I cant left anything up on the side I got my shot, my eyes keep getting watery. When I cant see good, when getting up in the morning I feel real tried

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Itching · Fatigue or tiredness

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness

Adult check-in
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Feeling abnormal, Headache, Vision blurred — Feeling: Fair · Site: Itching · Fever · Headache, Fatigue or tiredness

Free text: I want to wait til now to give you the info now around 7 pm I start feeling my worse I feel light headed head aches, blurry vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · Nausea

Adult check-in
2021-05-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-31
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-17
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-16
Survey response — 6 months, dose 2
MedDRA: No adverse event — Feeling: Good

Free text: I have no issues

MedDRA releases: 2024-11 · check-in free text available
2022-01-06
Dose 3 — Moderna
2022-01-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · None

Adult check-in
2022-01-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache

Adult check-in
2022-01-09
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness, Unevaluable event — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness

Free text: I feel dizzy, I literally headed

MedDRA releases: 2024-11 · check-in free text available
2022-01-10
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache

Adult check-in
2022-01-12
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache · Be unable to work or attend school

Adult check-in
2022-01-13
Survey response — day 7, dose 3
MedDRA: Malaise — Feeling: Fair · Be unable to work or attend school

Free text: Like I said I believe I had Covid when I got the booster so I don't know

MedDRA releases: 2024-11 · check-in free text available
2022-01-20
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-27
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-02-03
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-02-19
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-04-07
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-07-07
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-20	Moderna
2	2021-04-17	Moderna
3	2022-01-06	Moderna	No

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-24

Systemic reaction (other): When I got the shot it hurt 4 days I have a rash under my arm it swelling up and hurt

Release 7 — days 1–6 daily, dose 2

2021-04-18

Systemic reaction (other): My left eye keep watering up . On the same side I got my shit

2021-04-20

Systemic reaction (other): I cant left anything up on the side I got my shot, my eyes keep getting watery. When I cant see good, when getting up in the morning I feel real tried

2021-04-23

Systemic reaction (other): I want to wait til now to give you the info now around 7 pm I start feeling my worse I feel light headed head aches, blurry vision

Release 10 — 6 months, dose 2

2021-10-16

Symptoms: I have no issues

Release 10 — days 1–6 daily, dose 3

2022-01-09

Systemic reaction (other): I feel dizzy, I literally headed

Release 10 — day 7, dose 3

2022-01-13

Systemic reaction (other): Like I said I believe I had Covid when I got the booster so I don't know

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	No adverse event	·	·	✓
SRO	Axillary pain	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Lacrimation increased	✓	✓	✓
SRO	Malaise	·	·	✓
SRO	Oedema peripheral	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Unevaluable event	·	·	✓
SRO	Vision blurred	✓	✓	✓

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