2AU-72416-80199

5 vaccinations 7 coded responses 22 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 913 / CA
Registered: 2021-03-10

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-02-08
Dose 1 — Moderna
2021-03-08
Dose 2 — Moderna
2021-03-10
Registered in v-safe
2021-03-10
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Pain in extremity, Peripheral swelling, Rash, Self-medication — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches

Free text: Red , swelling , Rash of my entire upper arm. I have photos I can send. Yesterday the pain was bad but I did not get the bad swelling and Rash until Today. I take a 2 daily antihistamine

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

Adult check-in
2021-03-12
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Peripheral swelling — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Free text: The swelling on my arm has been 4 finger widths wide & long. The same with the Redness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Feeling hot, Pain, Pruritus, Swelling, Tenderness — Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Swelling is about the same 4-finger width/length size. But it is less red. It is still tender, hot, sore and itches.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Fatigue — Feeling: Fair · Site: Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Less Redness at the site but still swollen. Still very fatigued.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — day 7, dose 2
Feeling: Good · Site: Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-22
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-31
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-11
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-13
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-06-08
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-06
Survey response — 6 months, dose 2
MedDRA: Condition aggravated, Office visit, Pre-existing disease, Root canal infection, Swelling, Swelling face — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Last week I got a severe infection from a Root Canal procedure from 26 years ago that never gave me any trouble up till now. I now have an Endodontist to treat the infection and re-do the Root Canal. The pain meds made me sick. My jaw & neck swole. · Healthcare visit (other): 2 Dentist & 1 doctor Appointment

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-06
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-11
Call 2 — Left Voicemail
2021-09-23
Call 3 — Could Not Reach Participant
2021-09-23
Callback requested for
07:00PM ET
2021-09-29
Call X — Left Voicemail
2021-11-05
Dose 3 — Moderna
2022-03-09
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-11
Dose 4 — Pfizer-BioNTech
2022-04-24
Survey response — day 7, dose 4
MedDRA: Respiratory symptom, SARS-CoV-2 test negative — Feeling: Fair · Site: Pain · Headache · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Had URI symptoms this week. Tested Negative for Covid two times

MedDRA releases: 2024-11 · check-in free text available
2022-04-24
Report sent to call center — day 7, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-04-25
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-04-25
Call 1 — Left Voicemail
2022-05-02
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-05-11
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-16
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-24
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-11
Survey response — 3 months, dose 4
MedDRA: Dizziness, Office visit, Vomiting — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: Severe dizziness and vomiting - possibly A severe case of Vertigo- but not the typical positional type. · Healthcare visit (other): Follow up with Cardiologist & ENT for firm diagnosis

MedDRA releases: 2024-11 · check-in free text available
2022-07-11
Report sent to call center — 3 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-07-12
Call 1 — Left Voicemail
2022-07-12
Call 2 — Left Voicemail
2022-07-12
Call 1 — Left Voicemail
2022-11-16
Dose 5 — Pfizer-BioNTech
2023-04-12
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in
2023-05-20
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-08	Moderna
2	2021-03-08	Moderna
3	2021-11-05	Moderna	No
4	2022-04-11	Pfizer-BioNTech	No
5	2022-11-16	Pfizer-BioNTech	No

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-10

Systemic reaction (other): Red , swelling , Rash of my entire upper arm. I have photos I can send. Yesterday the pain was bad but I did not get the bad swelling and Rash until Today. I take a 2 daily antihistamine

2021-03-12

Systemic reaction (other): The swelling on my arm has been 4 finger widths wide & long. The same with the Redness.

2021-03-13

Systemic reaction (other): Swelling is about the same 4-finger width/length size. But it is less red. It is still tender, hot, sore and itches.

2021-03-14

Systemic reaction (other): Less Redness at the site but still swollen. Still very fatigued.

Release 9 — 6 months, dose 2

2021-09-06

Symptoms: Last week I got a severe infection from a Root Canal procedure from 26 years ago that never gave me any trouble up till now. I now have an Endodontist to treat the infection and re-do the Root Canal. The pain meds made me sick. My jaw & neck swole. cut off by CDC

Healthcare visit (other): 2 Dentist & 1 doctor Appointment

Release 11 — day 7, dose 4

2022-04-24

Systemic reaction (other): Had URI symptoms this week. Tested Negative for Covid two times

Release 12 — 3 months, dose 4

2022-07-11

Symptoms: Severe dizziness and vomiting - possibly A severe case of Vertigo- but not the typical positional type.

Healthcare visit (other): Follow up with Cardiologist & ENT for firm diagnosis

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
HCVO	Office visit	✓	·	✓
SD	Condition aggravated	✓	·	✓
SD	Dizziness	·	·	✓
SD	Office visit	✓	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Root canal infection	✓	·	✓
SD	Swelling	✓	·	✓
SD	Swelling face	✓	·	✓
SD	Vomiting	·	·	✓
SRO	Erythema	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling hot	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Respiratory symptom	·	·	✓
SRO	SARS-CoV-2 test negative	·	·	✓
SRO	Self-medication	✓	✓	✓
SRO	Swelling	✓	✓	✓
SRO	Tenderness	✓	✓	✓

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