2W8-16110-63385

4 vaccinations 6 coded responses 41 check-ins 6 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 920 / CA
Registered: 2021-02-06

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

2021-02-06
Registered in v-safe
2021-02-06
Dose 1 — Moderna
2021-02-06
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-02-13
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-02-20
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-27
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-11
Dose 2 — Moderna
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-16
Survey response — days 1–6 daily, dose 2
MedDRA: Contusion, Injection site pain, Injection site pruritus, Injection site reaction, Muscle swelling — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches

Free text: My arm muscle lower than the injection site bruised and has a strange swelling for no other reason. It hurts. The injection site itches mildly

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-18
Health check-in — day 7, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-10
Health check-in — 3 months, dose 2
Feeling: Good

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

Adult check-in
2021-10-01
Dose 3 — Moderna
Co-administered: Do not remember
2021-10-26
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-10-29
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-11-05
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-11-12
Survey response — day 42, dose 3
MedDRA: Anxiety, Nausea, Sinusitis — Feeling: Poor · 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: Low grade sinus infection, persistent nausea and suffocating anxiety

MedDRA releases: 2024-11 · check-in free text available
2021-11-12
Report sent to call center — day 42, dose 3
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)
2021-11-15
Call 2 — Could Not Reach Participant
2021-12-31
Survey response — 3 months, dose 3
MedDRA: Asthma, Cough, Oropharyngeal pain, Pre-existing disease, Pyrexia, SARS-CoV-2 test negative — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fever, sore throat, asthma flare up, cough, we think in for a standard covid test which takes 2-3 days. Results were, surprisingly, negative.

MedDRA releases: 2024-11 · check-in free text available
2022-01-21
Call 1 — Could Not Reach Participant
2022-04-02
Survey response — 6 months, dose 3
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: MRSA re-infection

MedDRA releases: 2024-11 · check-in free text available
2022-04-02
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-04-12
Call 1 — Left Voicemail
2022-09-14
Dose 4 — Moderna
Co-administered: Flu
2022-09-16
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache

Adult check-in
2022-09-17
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2022-09-18
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Swelling · Fatigue or tiredness

Adult check-in
2022-09-19
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · None · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Adult check-in
2022-09-19
Report sent to call center — days 1–6 daily, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-09-20
Survey response — days 1–6 daily, dose 4
MedDRA: Pre-existing disease — Feeling: Fair · Headache, Fatigue or tiredness

Free text: I am a pain patient and am scheduled tentatively for surgery next Wednesday, so my symptoms are not COVID vaccine related. Thank you so very much for your concern!!!

MedDRA releases: 2024-11 · check-in free text available
2022-09-20
Call successful
Not applicable - Accidental Reporting
2022-09-20
Call successful
Not applicable - Accidental Reporting
2022-09-20
Call successful
Not applicable - Accidental Reporting
2022-09-21
Health check-in — day 7, dose 4
Feeling: Fair · None

Adult check-in
2022-09-28
Survey response — day 14, dose 4
MedDRA: Hospitalisation — Feeling: Poor · Get care from a doctor or other healthcare professional · Hospitalization

Free text: In the hospital not COVID related

MedDRA releases: 2024-11 · check-in free text available
2022-09-28
Report sent to call center — day 14, dose 4
Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2022-09-29
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-05
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-10-12
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-19
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-10-26
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-14
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-15
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-06	Moderna
2	2021-03-11	Moderna
3	2021-10-01	Moderna	Do not remember
4	2022-09-14	Moderna	Flu

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-16

Systemic reaction (other): My arm muscle lower than the injection site bruised and has a strange swelling for no other reason. It hurts. The injection site itches mildly

Release 10 — day 42, dose 3

2021-11-12

Symptoms: Low grade sinus infection, persistent nausea and suffocating anxiety

Release 10 — 3 months, dose 3

2021-12-31

Symptoms: Fever, sore throat, asthma flare up, cough, we think in for a standard covid test which takes 2-3 days. Results were, surprisingly, negative.

Release 11 — 6 months, dose 3

2022-04-02

Symptoms: MRSA re-infection

Release 12 — days 1–6 daily, dose 4

2022-09-20

Systemic reaction (other): I am a pain patient and am scheduled tentatively for surgery next Wednesday, so my symptoms are not COVID vaccine related. Thank you so very much for your concern!!!

Release 12 — day 14, dose 4

2022-09-28

Symptoms: In the hospital not COVID related

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	Anxiety	·	·	✓
SD	Asthma	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Cough	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sinusitis	·	·	✓
SRO	Contusion	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	Injection site reaction	✓	✓	✓
SRO	Muscle swelling	✓	✓	✓
SRO	Pre-existing disease	·	·	✓

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