2PN-25656-87746

4 vaccinations 10 coded responses 39 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 334 / FL
Registered: 2021-01-25

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

2021-01-16
Dose 1 — Moderna
2021-01-25
Registered in v-safe
2021-01-25
Survey response — day 7, dose 1
MedDRA: Adverse reaction — Feeling: Fair · Site: Redness, Swelling, Itching

Free text: these symptoms appeared a week after shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Survey response — day 14, dose 1
MedDRA: Abdominal pain upper, Diarrhoea, Feeling of body temperature change, Immunisation reaction — Feeling: Fair · Be unable to do your normal daily activities

Free text: Covid arm reaction to vaccine going on 7 days. Last night had stomach pain, hot and cold and diarrhea. Don't know if this is related though

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — day 21, dose 1
MedDRA: Erythema, Eye pruritus, Pruritus — Feeling: Good

Free text: The itching and redness in my shot arm finally cleared. Now there a general itchy feeling all over but especially in my eyes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Dose 2 — Moderna
2021-02-13
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain — Feeling: Good · Site: Pain

Free text: Still pain at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-18
Survey response — days 1–6 daily, dose 2
MedDRA: Eyelids pruritus, Swelling of eyelid — Feeling: Fair · Site: Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Eye lid swelling and extreme itch

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-27
Survey response — day 14, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Extremely fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — day 21, dose 2
MedDRA: Cold sweat, Fatigue — Feeling: Good · Be unable to do your normal daily activities

Free text: Extreme fatigue Cold sweats

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-15
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-15
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-26
Dose 3 — Moderna
2021-11-07
Survey response — day 7, dose 3
MedDRA: Pruritus — Feeling: Fair · Site: Pain, Redness, Swelling, Itching

Free text: Itching is very very strong

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Survey response — day 14, dose 3
MedDRA: Pruritus — Feeling: Fair

Free text: Severe itching on injection arm

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-23
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-30
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-07
Survey response — day 42, dose 3
MedDRA: Eye infection, Pruritus — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Arm still itches Eye infection

MedDRA releases: 2024-11 · check-in free text available
2021-12-07
Report sent to call center — day 42, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-08
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-01-25
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-28
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-22
Dose 4 — Pfizer-BioNTech
2022-10-22
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-10-23
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-24
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-25
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-26
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fever · Chills, Abdominal pain

Adult check-in
2022-10-27
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Abdominal pain

Adult check-in
2022-10-28
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Abdominal pain

Adult check-in
2022-10-29
Health check-in — day 7, dose 4
Feeling: Good · Abdominal pain

Adult check-in
2022-11-05
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-11-12
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-12-05
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-01-21
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-04-22
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-16	Moderna
2	2021-02-13	Moderna
3	2021-10-26	Moderna	No
4	2022-10-22	Pfizer-BioNTech	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 2 — day 7, dose 1

2021-01-25

Systemic reaction (other): these symptoms appeared a week after shot

Release 3 — day 14, dose 1

2021-01-30

Symptoms: Covid arm reaction to vaccine going on 7 days. Last night had stomach pain, hot and cold and diarrhea. Don't know if this is related though

Release 3 — day 21, dose 1

2021-02-06

Symptoms: The itching and redness in my shot arm finally cleared. Now there a general itchy feeling all over but especially in my eyes.

Release 4 — days 1–6 daily, dose 2

2021-02-15

Systemic reaction (other): Still pain at injection site

2021-02-18

Systemic reaction (other): Eye lid swelling and extreme itch

Release 4 — day 14, dose 2

2021-02-27

Symptoms: Extremely fatigue

Release 5 — day 21, dose 2

2021-03-06

Symptoms: Extreme fatigue Cold sweats

Release 10 — day 7, dose 3

2021-11-07

Systemic reaction (other): Itching is very very strong

Release 10 — day 14, dose 3

2021-11-09

Symptoms: Severe itching on injection arm

Release 10 — day 42, dose 3

2021-12-07

Symptoms: Arm still itches Eye infection

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 pain upper	✓	✓	✓
SD	Cold sweat	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Eye infection	·	·	✓
SD	Eye pruritus	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeling of body temperature change	✓	✓	✓
SD	Immunisation reaction	✓	✓	✓
SD	Pruritus	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Eyelids pruritus	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Pruritus	·	·	✓
SRO	Swelling of eyelid	✓	✓	✓

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