2HL-26266-20406

3 vaccinations 5 coded responses 36 check-ins 5 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 786 / TX
Registered: 2021-01-15

Relationship: Self
Race: White
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

2021-01-15
Registered in v-safe
2021-01-15
Dose 1 — Moderna
2021-01-15
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: Immediate post-injection reaction, Nausea — Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Free text: Felt nauseated a few minutes after receiving vaccine. Lasted about 15 minutes then disappeared. None since.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

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

Adult check-in
2021-01-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-01-22
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-01-29
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling — Feeling: Good

Free text: Developed a large (approx. 4-5) red, swollen, itchy, somewhat painful area on my arm where I received vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — day 21, dose 1
MedDRA: Rash, Rash erythematous, Rash pruritic — Feeling: Good

Free text: Rash expanded to my lower back area, very itchy, but improved today. Also developed rash on upper chest and arms. The rash appears like small rosey spots, not raised or swollen.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — day 28, dose 1
MedDRA: Oedema peripheral, Peripheral swelling, Pruritus, Self-medication — Feeling: Good

Free text: The upper part of my left foot from toes to ankles became itchy, red and swollen. Put benadyl on the area. Slightly red and swollen but not titchy anymore.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-02-21
Dose 2 — Moderna
2021-02-25
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Chills, Decreased appetite, Dyspepsia, Fatigue, Insomnia, Loss of personal independence in daily activities, Nausea, Pain in extremity, Pyrexia — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Had 2nd vaccine on Sunday, 2/21, developed fever up to 100.8, nausea, indigestion, arm pain, weakness ( had to be helped to stand and helped into bed), could not sleep because of various before mentioned symptoms. On Monday, had fever all day, very fatigued, no appetite, slept most of day , had chills, slept all night, fever abated By Tuesday afternoon. Wednesday still fatigued but generally felt better and stronger. Still no appetite.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-02-28
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-14
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-21
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-28
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-04
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-23
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-22
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-21
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-06-24
Dose 3 — Moderna
2022-06-26
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches

Adult check-in
2022-06-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Chills, Muscle or body aches, Rash, not including the immediate area around the injection site

Adult check-in
2022-06-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling, Itching · Rash, not including the immediate area around the injection site

Adult check-in
2022-06-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2022-06-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2022-07-01
Health check-in — day 7, dose 3
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2022-07-09
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-07-16
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-07-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-07-29
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-08-08
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-09-23
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-12-26
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-15	Moderna
2	2021-02-21	Moderna
3	2022-06-24	Moderna	No

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-17

Systemic reaction (other): Felt nauseated a few minutes after receiving vaccine. Lasted about 15 minutes then disappeared. None since.

Release 3 — day 14, dose 1

2021-01-29

Symptoms: Developed a large (approx. 4-5) red, swollen, itchy, somewhat painful area on my arm where I received vaccine

Release 3 — day 21, dose 1

2021-02-05

Symptoms: Rash expanded to my lower back area, very itchy, but improved today. Also developed rash on upper chest and arms. The rash appears like small rosey spots, not raised or swollen.

Release 4 — day 28, dose 1

2021-02-12

Symptoms: The upper part of my left foot from toes to ankles became itchy, red and swollen. Put benadyl on the area. Slightly red and swollen but not titchy anymore.

Release 4 — days 1–6 daily, dose 2

2021-02-25

Systemic reaction (other): Had 2nd vaccine on Sunday, 2/21, developed fever up to 100.8, nausea, indigestion, arm pain, weakness ( had to be helped to stand and helped into bed), could not sleep because of various before mentioned symptoms. On Monday, had fever all day, very fatigued, no appetite, slept most of day , had chills, slept all night, fever abated By Tuesday afternoon. Wednesday still fatigued but generally felt better and stronger. Still no appetite.

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	Injection site erythema	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Oedema peripheral	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash erythematous	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SD	Self-medication	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Dyspepsia	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Loss of personal independence in daily activities	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pyrexia	✓	✓	✓

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