37W-20848-46416

2 vaccinations 5 coded responses 25 check-ins 5 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 216 / MD
Registered: 2021-04-13

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

2021-04-13
Registered in v-safe
2021-04-13
Dose 1 — Moderna
2021-04-13
Survey response — day 0, dose 1
MedDRA: Paraesthesia, Pruritus — Feeling: Good · Site: Pain, Itching · Chills, Headache, Fatigue or tiredness, Nausea

Free text: Right hand and foot tingling and itching a little for the first first half hour. Didn't normally do that. Had shit in right arm. Tolerable.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 1
MedDRA: Chills, Feeling cold, Nasopharyngitis, Peripheral coldness, Pyrexia — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Freezing cold and fever at the same time feeling. Hands cold as ice arms hot, teeth chattering at times

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Chills, Headache, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-20
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-11
Dose 2 — Moderna
2021-05-11
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Itching · Headache, Nausea

Adult check-in
2021-05-12
Survey response — days 1–6 daily, dose 2
MedDRA: Pyrexia — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Fever set in four thirty yesterday. Coming down now

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling · Headache, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-05-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-18
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-24
Survey response — day 42, dose 2
MedDRA: Pruritus, Rash — Feeling: Good

Free text: Had a strange rash for a few days on and she itching of fingers and toes internally . Better now. Not sure if related.a little short of breathe.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-10
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-05-11
Survey response — 12 months, dose 2
MedDRA: Computerised tomogram abnormal, Emergency care, Immunisation reaction, Office visit, Pain, Pre-existing disease — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: COVID lung detected . Having some pain. Waiting on referral to pulmonologist. Missed a few days of work. To the emergency room and cat scan showed nodules calcified and non calcified but there before COVID · Healthcare visit (other): Er u regular doctor to imaging center . Trying to get a lung doctor referral who will take my insurance

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-05-12
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-13	Moderna
2	2021-05-11	Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 7 — day 0, dose 1

2021-04-13

Systemic reaction (other): Right hand and foot tingling and itching a little for the first first half hour. Didn't normally do that. Had shit in right arm. Tolerable.

Release 7 — days 1–6 daily, dose 1

2021-04-14

Systemic reaction (other): Freezing cold and fever at the same time feeling. Hands cold as ice arms hot, teeth chattering at times

Release 8 — days 1–6 daily, dose 2

2021-05-12

Systemic reaction (other): Fever set in four thirty yesterday. Coming down now

Release 9 — day 42, dose 2

2021-06-24

Symptoms: Had a strange rash for a few days on and she itching of fingers and toes internally . Better now. Not sure if related.a little short of breathe.

Release 11 — 12 months, dose 2

2022-05-11

Symptoms: COVID lung detected . Having some pain. Waiting on referral to pulmonologist. Missed a few days of work. To the emergency room and cat scan showed nodules calcified and non calcified but there before COVID

Healthcare visit (other): Er u regular doctor to imaging center . Trying to get a lung doctor referral who will take my insurance

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
HCVO	Emergency care	·	·	✓
HCVO	Office visit	·	·	✓
SD	Computerised tomogram abnormal	·	·	✓
SD	Emergency care	·	·	✓
SD	Immunisation reaction	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Feeling cold	✓	✓	✓
SRO	Nasopharyngitis	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Peripheral coldness	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Pyrexia	✓	✓	✓

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