28R-10287-65396

3 vaccinations 4 coded responses 35 check-ins 4 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 018 / MA
Registered: 2021-01-18

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

2021-01-18
Registered in v-safe
2021-01-18
Dose 1 — Moderna
2021-01-18
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-25
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-08
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-15
Dose 2 — Moderna
2021-02-15
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-17
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Insomnia — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I forgot to report that following both vaccines I experienced significant sleep disruption waking up every 10 to 20 minutes through most of the night but without a fever or other physical symptoms other than shoulder pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-08
Survey response — day 21, dose 2
MedDRA: Pre-existing disease — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: I am having am exacerbation of symptoms that predate my vaccine and that routinely ebb and flow and are not related to the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-22
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-16
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Dose 3 — Moderna
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-29
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-05
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-21
Survey response — 3 months, dose 3
MedDRA: Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Symptoms from a chronic condition that predates COVID relating to allergies and sensitivity to histamines

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-22
Survey response — 12 months, dose 3
MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, 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: Covid-19 in September

MedDRA releases: 2024-11 · check-in free text available
2022-10-22
Report sent to call center — 12 months, 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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-10-25
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	2021-01-18	Moderna
2	2021-02-15	Moderna
3	2021-10-22	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-17

Systemic reaction (other): I forgot to report that following both vaccines I experienced significant sleep disruption waking up every 10 to 20 minutes through most of the night but without a fever or other physical symptoms other than shoulder pain.

Release 5 — day 21, dose 2

2021-03-08

Symptoms: I am having am exacerbation of symptoms that predate my vaccine and that routinely ebb and flow and are not related to the vaccine

Release 11 — 3 months, dose 3

2022-01-21

Symptoms: Symptoms from a chronic condition that predates COVID relating to allergies and sensitivity to histamines

Release 12 — 12 months, dose 3

2022-10-22

Symptoms: Covid-19 in September

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	COVID-19	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Insomnia	✓	✓	✓

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