2NJ-18656-47786

4 vaccinations 21 coded responses 55 check-ins 21 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 980 / WA
Registered: 2021-02-16

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

2021-02-15
Dose 1 — Moderna
2021-02-16
Registered in v-safe
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-18
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal discomfort, Irritable bowel syndrome, Nausea — Feeling: Good · Site: Pain

Free text: I had some mild nausea/stomach upset Tues/Wed but not dilute its the vaccine as I have IBS. Better today though

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-02-21
Survey response — days 1–6 daily, dose 1
MedDRA: Headache, Pain in extremity — Feeling: Good · Headache

Free text: Mild headache again. Yesterday I also had done arm pain after I submitted my report but think it was aggravated by some housework I was doing?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-01
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-08
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-15
Dose 2 — Moderna
2021-03-15
Health check-in — day 0, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-16
Survey response — days 1–6 daily, dose 2
MedDRA: Hyperventilation — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: A little hyperventilating (have asthma)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — days 1–6 daily, dose 2
MedDRA: Malaise, Pyrexia — Feeling: Fair · Site: Redness · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Fever hit 101.1 last night, very ill all day ; began improving around 10 pm 3/16

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness · None

Adult check-in
2021-03-19
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite, Hypersomnia, Weight decreased — Feeling: Fair · Site: Pain, Redness · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Slept til noon today. Have lost 8 lbs this week. No appetite. Can taste food give just no appetite.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-21
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Somnolence — Feeling: Good

Free text: I will say I have slept more at night lately than usual so could be fatigue?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-19
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-26
Survey response — day 42, dose 2
MedDRA: Cystitis, Musculoskeletal discomfort, Renal impairment — Feeling: Fair · Be unable to do your normal daily activities

Free text: Bladder Infection, decreased kidney function, back problems...likely unrelated

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-14
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-13
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-03
Dose 3 — Moderna
2021-11-03
Health check-in — day 0, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-05
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Very swollen nymph mode in armpit (arm where I got the booster)

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Survey response — days 1–6 daily, dose 3
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Lymph node in armpit remains quite swollen and sore

MedDRA releases: 2024-11 · check-in free text available
2021-11-07
Survey response — days 1–6 daily, dose 3
MedDRA: Diarrhoea, Lymphadenopathy, Pre-existing disease, Vomiting — Feeling: Good · Site: Pain · Vomiting, Diarrhea · Be unable to do your normal daily activities

Free text: Lymph node in armpit still swollen. Pretty sure the vomiting/diarrhea was due to my IBS-D

MedDRA releases: 2024-11 · check-in free text available
2021-11-08
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain

Free text: Just that swollen lymph node in the armpit but it's better

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-10
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-17
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-24
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-15
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-02
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-05-04
Survey response — 6 months, dose 3
MedDRA: Cystitis haemorrhagic, Hiatus hernia, Knee arthroplasty — Feeling: Fair · Be unable to do your normal daily activities

Free text: Hemorrhagic cystitis, left knee total replacement 4/20, hiatal hernia

MedDRA releases: 2024-11 · check-in free text available
2022-06-30
Dose 4 — Moderna
2022-06-30
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-07-01
Survey response — days 1–6 daily, dose 4
MedDRA: Abdominal pain, Diarrhoea, Pre-existing disease — Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: I do have IBS-D so hard to know if the abdominal pain or diarrhea is from that or the vaccine. Also my normal temp is 97.3

MedDRA releases: 2024-11 · check-in free text available
2022-07-02
Survey response — days 1–6 daily, dose 4
MedDRA: Dizziness, Oropharyngeal pain — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Free text: Sore throat, dizziness (which came on about 22 hours ago)

MedDRA releases: 2024-11 · check-in free text available
2022-07-03
Survey response — days 1–6 daily, dose 4
MedDRA: Dizziness, Pre-existing disease, Vertigo — Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness

Free text: Dizziness/vertigo; I have been diagnosed years ago with benign positional vertigo

MedDRA releases: 2024-11 · check-in free text available
2022-07-04
Survey response — days 1–6 daily, dose 4
MedDRA: Vertigo — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Continued vertigo issues

MedDRA releases: 2024-11 · check-in free text available
2022-07-05
Survey response — days 1–6 daily, dose 4
MedDRA: Vertigo — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Vertigo is improved

MedDRA releases: 2024-11 · check-in free text available
2022-07-06
Survey response — days 1–6 daily, dose 4
MedDRA: Vertigo — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Overall better, vertigo continues to improve

MedDRA releases: 2024-11 · check-in free text available
2022-07-07
Survey response — day 7, dose 4
MedDRA: Vertigo — Feeling: Fair · Fatigue or tiredness

Free text: Still having morning vertigo

MedDRA releases: 2024-11 · check-in free text available
2022-07-14
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-07-21
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-07-28
Survey response — day 28, dose 4
MedDRA: Cough, Headache, Pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative, Vertigo — Feeling: Poor · Be unable to do your normal daily activities

Free text: Runny nose, congestion, cough, fever, body aches, headaches, vertigo ; tested negative for Covid twice at home but I got a Covid test at a local clinic this morning. Waiting for results.

MedDRA releases: 2024-11 · check-in free text available
2022-08-04
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-08-11
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-09-29
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-12-29
Survey response — 6 months, dose 4
MedDRA: Cough, Nasopharyngitis, Vertigo positional, Viral infection — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: BPPV cold/virus/cough

MedDRA releases: 2024-11 · check-in free text available
2022-12-29
Report sent to call center — 6 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-30
Call 2 — Left Voicemail
2023-01-06
Call 1 — Left Voicemail
2023-01-11
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-06-30
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-15	Moderna
2	2021-03-15	Moderna
3	2021-11-03	Moderna	No
4	2022-06-30	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-18

Systemic reaction (other): I had some mild nausea/stomach upset Tues/Wed but not dilute its the vaccine as I have IBS. Better today though

2021-02-21

Systemic reaction (other): Mild headache again. Yesterday I also had done arm pain after I submitted my report but think it was aggravated by some housework I was doing?

Release 5 — days 1–6 daily, dose 2

2021-03-16

Systemic reaction (other): A little hyperventilating (have asthma)

2021-03-17

Systemic reaction (other): Fever hit 101.1 last night, very ill all day ; began improving around 10 pm 3/16

2021-03-19

Systemic reaction (other): Slept til noon today. Have lost 8 lbs this week. No appetite. Can taste food give just no appetite.

Release 6 — days 1–6 daily, dose 2

2021-03-21

Systemic reaction (other): I will say I have slept more at night lately than usual so could be fatigue?

Release 7 — day 42, dose 2

2021-04-26

Symptoms: Bladder Infection, decreased kidney function, back problems...likely unrelated

Release 10 — days 1–6 daily, dose 3

2021-11-05

Systemic reaction (other): Very swollen nymph mode in armpit (arm where I got the booster)

2021-11-06

Systemic reaction (other): Lymph node in armpit remains quite swollen and sore

2021-11-07

Systemic reaction (other): Lymph node in armpit still swollen. Pretty sure the vomiting/diarrhea was due to my IBS-D

2021-11-08

Systemic reaction (other): Just that swollen lymph node in the armpit but it's better

Release 11 — 6 months, dose 3

2022-05-04

Symptoms: Hemorrhagic cystitis, left knee total replacement 4/20, hiatal hernia

Release 12 — days 1–6 daily, dose 4

2022-07-01

Systemic reaction (other): I do have IBS-D so hard to know if the abdominal pain or diarrhea is from that or the vaccine. Also my normal temp is 97.3

2022-07-02

Systemic reaction (other): Sore throat, dizziness (which came on about 22 hours ago)

2022-07-03

Systemic reaction (other): Dizziness/vertigo; I have been diagnosed years ago with benign positional vertigo

2022-07-04

Systemic reaction (other): Continued vertigo issues

2022-07-05

Systemic reaction (other): Vertigo is improved

2022-07-06

Systemic reaction (other): Overall better, vertigo continues to improve

Release 12 — day 7, dose 4

2022-07-07

Systemic reaction (other): Still having morning vertigo

Release 12 — day 28, dose 4

2022-07-28

Symptoms: Runny nose, congestion, cough, fever, body aches, headaches, vertigo ; tested negative for Covid twice at home but I got a Covid test at a local clinic this morning. Waiting for results.

Release 12 — 6 months, dose 4

2022-12-29

Symptoms: BPPV cold/virus/cough

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	Cough	·	·	✓
SD	Cystitis	✓	✓	✓
SD	Cystitis haemorrhagic	·	·	✓
SD	Headache	·	·	✓
SD	Hiatus hernia	·	·	✓
SD	Knee arthroplasty	·	·	✓
SD	Musculoskeletal discomfort	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Renal impairment	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Vertigo	·	·	✓
SD	Vertigo positional	·	·	✓
SD	Viral infection	·	·	✓
SRO	Abdominal discomfort	✓	✓	✓
SRO	Abdominal pain	·	·	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Diarrhoea	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hypersomnia	✓	✓	✓
SRO	Hyperventilation	✓	✓	✓
SRO	Irritable bowel syndrome	✓	✓	✓
SRO	Lymph node pain	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Malaise	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pre-existing disease	·	·	✓
SRO	Pyrexia	✓	✓	✓
SRO	Somnolence	✓	✓	✓
SRO	Vertigo	·	·	✓
SRO	Vomiting	·	·	✓
SRO	Weight decreased	✓	✓	✓

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