2MQ-15066-03604

4 vaccinations 9 coded responses 31 check-ins 9 free-text entries 0 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 891 / NV
Registered: 2021-03-17

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

2021-03-17
Registered in v-safe
2021-03-17
Dose 1 — Moderna
2021-03-17
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-24
Survey response — day 7, dose 1
MedDRA: Dizziness, Vertigo — Feeling: Fair

Free text: Mild vertigo/dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-07
Survey response — day 21, dose 1
MedDRA: Abdominal discomfort, Diarrhoea — Feeling: Good

Free text: Gastrointestinal upset including diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Dose 2 — Moderna
2021-04-14
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Episode of dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Diarrhea

Adult check-in
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Blepharitis, Condition aggravated, Pre-existing disease — Feeling: Fair · Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Flare up of blepharitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — day 7, dose 2
Feeling: Good · Diarrhea

Adult check-in
2021-04-28
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-05
Survey response — day 21, dose 2
MedDRA: Diarrhoea — Feeling: Good

Free text: Occasional diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-26
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-16
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-13
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-21
Dose 3 — Moderna
2022-05-26
Dose 4 — Moderna
2022-05-30
Survey response — days 1–6 daily, dose 4
MedDRA: Phlebitis, Varicophlebitis — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Varicose veins in.leg on side of shot are inflamed (noticed areas of phlebitis 2 days after shot)

MedDRA releases: 2024-11 · check-in free text available
2022-06-01
Survey response — days 1–6 daily, dose 4
MedDRA: Phlebitis, Pre-existing disease — Feeling: Fair · Site: Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Phlebitis at various points on varicose veins in lower right leg (same side as injection site)

MedDRA releases: 2024-11 · check-in free text available
2022-06-02
Survey response — day 7, dose 4
MedDRA: Phlebitis — Feeling: Fair · Site: Itching · Joint pains, Fatigue or tiredness

Free text: Phlebitis spots on varicose veins on lower right leg (same side as injection)

MedDRA releases: 2024-11 · check-in free text available
2022-06-09
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-19
Survey response — day 21, dose 4
MedDRA: Ligament sprain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sprained knee

MedDRA releases: 2024-11 · check-in free text available
2022-06-26
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-07-03
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-09
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-25
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-26
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-17	Moderna
2	2021-04-14	Moderna
3	2021-11-21	Moderna	No
4	2022-05-26	Moderna	No

Free text

Release 6 — day 7, dose 1

2021-03-24

Systemic reaction (other): Mild vertigo/dizziness

Release 7 — day 21, dose 1

2021-04-07

Symptoms: Gastrointestinal upset including diarrhea

Release 7 — days 1–6 daily, dose 2

2021-04-15

Systemic reaction (other): Episode of dizziness

2021-04-17

Systemic reaction (other): Flare up of blepharitis

Release 8 — day 21, dose 2

2021-05-05

Symptoms: Occasional diarrhea

Release 11 — days 1–6 daily, dose 4

2022-05-30

Systemic reaction (other): Varicose veins in.leg on side of shot are inflamed (noticed areas of phlebitis 2 days after shot)

2022-06-01

Systemic reaction (other): Phlebitis at various points on varicose veins in lower right leg (same side as injection site)

Release 11 — day 7, dose 4

2022-06-02

Systemic reaction (other): Phlebitis spots on varicose veins on lower right leg (same side as injection)

Release 12 — day 21, dose 4

2022-06-19

Symptoms: Sprained knee

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	Abdominal discomfort	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Ligament sprain	·	·	✓
SRO	Blepharitis	✓	✓	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Phlebitis	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Varicophlebitis	·	·	✓
SRO	Vertigo	✓	✓	✓

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