33D-31310-06713

5 vaccinations 16 coded responses 47 check-ins 16 free-text entries 0 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 214 / MD
Registered: 2021-04-08

Relationship: Self
Race: Multiracial
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

2021-04-08
Registered in v-safe
2021-04-08
Dose 1 — Moderna
2021-04-08
Survey response — day 0, dose 1
MedDRA: Pain in extremity — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Received injection in left arm. My entire left arm is aching.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Poor · Site: Pain, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Entire left arm (injection site) aching and sore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-13
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Pain — Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Tried to get up and get moving since vaccine and noticed more aches and fatigue today than yesterday (while still resting.)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-22
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-06
Dose 2 — Moderna
2021-05-06
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-05-07
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Cough, Dry eye, Dry mouth, Injection site pain, Pain — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Mild Cough, Dry Mouth & Eyes & Intermitent Sharp shooting Pain from Deltoid to Elbow in Left Arm (injection site)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain, Diarrhoea, Dry eye, Injection site induration, Injection site pain — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Very Dry Eyes persist, Two bouts of Abdominal Cramping followed by Diarrhea, which occurred once last evening and once today. Firm area on left arm over injection site is less tense and more diffuse but still tender.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-05-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-05-15
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-04
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-07
Dose 3 — Moderna
Co-administered: Flu
2021-11-07
Health check-in — day 0, dose 3
Feeling: Good · Site: Swelling · None

Adult check-in
2021-11-08
Survey response — days 1–6 daily, dose 3
MedDRA: Pre-existing disease, Sensitivity to weather change, Wheezing — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Mild wheezing. I have asthma & this wheezing is most likely related to exposure to cold weather yesterday. Wheezing corrected by Proair inhaler.

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-11-22
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-30
Survey response — day 21, dose 3
MedDRA: Oedema, Oedema peripheral — Feeling: Good

Free text: I mistakenly omitted a problem that started a day or two after my covid booster and flu vaccine. I developed bilateral pitting edema in my lower legs, ankles & feet. It was persistent for the 1st two wks post-vaccines but is intermittent now. Unusual

MedDRA releases: 2024-11 · check-in free text available
2021-12-05
Health check-in — day 28, dose 3
Feeling: Good

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

Adult check-in
2021-12-20
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-07
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-21
Dose 4 — Moderna
2022-04-21
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-04-22
Survey response — days 1–6 daily, dose 4
MedDRA: Injection site induration, Injection site warmth — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Warmth & firmness extending ~ 5cm radius from injection site on right upper arm

MedDRA releases: 2024-11 · check-in free text available
2022-04-23
Survey response — days 1–6 daily, dose 4
MedDRA: Dehydration, Dizziness postural, Nasal congestion, Throat irritation, Vertigo positional — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Mild nasal congestion began yesterday. No nasal discharge. Scratchy throat today. Dizziness with position change, probably r/t dehydration. Occasional vertigo while lying flat.

MedDRA releases: 2024-11 · check-in free text available
2022-04-24
Survey response — days 1–6 daily, dose 4
MedDRA: Decreased appetite, Petechiae, Visual acuity reduced — Feeling: Good · Site: Pain, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: No appetite. Noticed Petechiae on both arms. Cannot differentiate if rash appears on other parts of my body due to normal limited visual acuity.

MedDRA releases: 2024-11 · check-in free text available
2022-04-25
Survey response — days 1–6 daily, dose 4
MedDRA: Decreased appetite, Petechiae — Feeling: Fair · Site: Pain, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: No appetite. Petechiae on arms persist.

MedDRA releases: 2024-11 · check-in free text available
2022-04-26
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-30
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-06
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-12
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-19
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-29
Survey response — day 35, dose 4
MedDRA: Asthenia, Fatigue, Mobility decreased, Somnolence — Feeling: Fair · Be unable to do your normal daily activities

Free text: For about 10 days now, I have experienced severe fatigue and generalized feeling of weakness. I am in bed, sleeping all hours of the day. The lack of energy is similar to that of hypoglycemia but it is within normal. Onset was sudden.

MedDRA releases: 2024-11 · check-in free text available
2022-07-21
Survey response — 3 months, dose 4
MedDRA: Petechiae — Feeling: Good

Free text: I started with Petechiae on my arms after my last booster. The Petechiae has spread to my lower legs, also. No signs or symptoms of infection. Haven't had access to health care for many months; but, I will see PrimaryDr in am. Will address rash.

MedDRA releases: 2024-11 · check-in free text available
2022-09-18
Dose 5 — Moderna
Co-administered: Flu
2022-09-18
Survey response — day 0, dose 5
MedDRA: Injection site induration, Injection site pain, Injection site swelling, Injection site warmth — Feeling: Good · Site: Pain, Swelling

Free text: In addition to pain & swelling at the injection site on (R) upper arm, there is a 3" diameter of firmness and warmth which is consistent with the swelling.

MedDRA releases: 2024-11 · check-in free text available
2022-09-19
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-09-20
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-09-21
Survey response — days 1–6 daily, dose 5
MedDRA: Ear discomfort, Ear pruritus, Oropharyngeal pain, Throat irritation — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Beginning last evening, I noticed a scratchy, mildly sore throat intermittently, as well as an itchy, clogged left ear canal. No appetite x3 days.

MedDRA releases: 2024-11 · check-in free text available
2022-09-22
Survey response — days 1–6 daily, dose 5
MedDRA: Injection site reaction — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Forgot to mentionall injection site symptoms reported are on the right arm, where the Covid injection was received. The left arm, where the flu shot was received remains asymptomatic.

MedDRA releases: 2024-11 · check-in free text available
2022-09-23
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-09-24
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-09-25
Health check-in — day 7, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-08	Moderna
2	2021-05-06	Moderna
3	2021-11-07	Moderna	Flu
4	2022-04-21	Moderna	No
5	2022-09-18	Moderna	Flu

Free text

Release 7 — day 0, dose 1

2021-04-08

Systemic reaction (other): Received injection in left arm. My entire left arm is aching.

Release 7 — days 1–6 daily, dose 1

2021-04-09

Systemic reaction (other): Entire left arm (injection site) aching and sore

2021-04-13

Systemic reaction (other): Tried to get up and get moving since vaccine and noticed more aches and fatigue today than yesterday (while still resting.)

Release 8 — days 1–6 daily, dose 2

2021-05-07

Systemic reaction (other): Mild Cough, Dry Mouth & Eyes & Intermitent Sharp shooting Pain from Deltoid to Elbow in Left Arm (injection site)

2021-05-10

Systemic reaction (other): Very Dry Eyes persist, Two bouts of Abdominal Cramping followed by Diarrhea, which occurred once last evening and once today. Firm area on left arm over injection site is less tense and more diffuse but still tender.

Release 10 — days 1–6 daily, dose 3

2021-11-08

Systemic reaction (other): Mild wheezing. I have asthma & this wheezing is most likely related to exposure to cold weather yesterday. Wheezing corrected by Proair inhaler.

Release 10 — day 21, dose 3

2021-11-30

Symptoms: I mistakenly omitted a problem that started a day or two after my covid booster and flu vaccine. I developed bilateral pitting edema in my lower legs, ankles & feet. It was persistent for the 1st two wks post-vaccines but is intermittent now. Unusual cut off by CDC

Release 11 — days 1–6 daily, dose 4

2022-04-22

Systemic reaction (other): Warmth & firmness extending ~ 5cm radius from injection site on right upper arm

2022-04-23

Systemic reaction (other): Mild nasal congestion began yesterday. No nasal discharge. Scratchy throat today. Dizziness with position change, probably r/t dehydration. Occasional vertigo while lying flat.

2022-04-24

Systemic reaction (other): No appetite. Noticed Petechiae on both arms. Cannot differentiate if rash appears on other parts of my body due to normal limited visual acuity.

2022-04-25

Systemic reaction (other): No appetite. Petechiae on arms persist.

Release 11 — day 35, dose 4

2022-05-29

Symptoms: For about 10 days now, I have experienced severe fatigue and generalized feeling of weakness. I am in bed, sleeping all hours of the day. The lack of energy is similar to that of hypoglycemia but it is within normal. Onset was sudden.

Release 12 — 3 months, dose 4

2022-07-21

Symptoms: I started with Petechiae on my arms after my last booster. The Petechiae has spread to my lower legs, also. No signs or symptoms of infection. Haven't had access to health care for many months; but, I will see PrimaryDr in am. Will address rash.

Release 12 — day 0, dose 5

2022-09-18

Systemic reaction (other): In addition to pain & swelling at the injection site on (R) upper arm, there is a 3" diameter of firmness and warmth which is consistent with the swelling.

Release 12 — days 1–6 daily, dose 5

2022-09-21

Systemic reaction (other): Beginning last evening, I noticed a scratchy, mildly sore throat intermittently, as well as an itchy, clogged left ear canal. No appetite x3 days.

2022-09-22

Systemic reaction (other): Forgot to mentionall injection site symptoms reported are on the right arm, where the Covid injection was received. The left arm, where the flu shot was received remains asymptomatic.

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	Asthenia	·	·	✓
SD	Fatigue	·	·	✓
SD	Mobility decreased	·	·	✓
SD	Oedema	·	·	✓
SD	Oedema peripheral	·	·	✓
SD	Petechiae	·	·	✓
SD	Somnolence	·	·	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Decreased appetite	·	·	✓
SRO	Dehydration	·	·	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Dizziness postural	·	·	✓
SRO	Dry eye	✓	✓	✓
SRO	Dry mouth	✓	✓	✓
SRO	Ear discomfort	·	·	✓
SRO	Ear pruritus	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Injection site induration	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site reaction	·	·	✓
SRO	Injection site swelling	·	·	✓
SRO	Injection site warmth	·	·	✓
SRO	Nasal congestion	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Petechiae	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Sensitivity to weather change	·	·	✓
SRO	Throat irritation	·	·	✓
SRO	Vertigo positional	·	·	✓
SRO	Visual acuity reduced	·	·	✓
SRO	Wheezing	·	·	✓

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