399-11245-35738

4 vaccinations 10 coded responses 34 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 928 / CA
Registered: 2021-02-17

Relationship: Self
Race: Asian
Ethnicity: Not Hispanic or Latino

Registered dependents

GDF-49056-35574 Adult relative or friend · Male · 2022-10-30

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-02-17
Registered in v-safe
2021-02-17
Dose 1 — Moderna
2021-02-17
Survey response — day 0, dose 1
MedDRA: Pruritus — Feeling: Fair · Site: Pain, Swelling · Joint pains · Be unable to do your normal daily activities

Free text: Some itchiness on a small area of the right palm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal pain upper, Faeces soft — Feeling: Good · Site: Pain · Abdominal pain

Free text: Epigastric pain and 1 episode of soft (not watery) stools

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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: Abdominal pain upper — Feeling: Good · Abdominal pain

Free text: Epigastric pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal pain upper — Feeling: Good · Abdominal pain

Free text: Epigastric pain, but could be related to spicy food I ate.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-03
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth, Medical counselling, Urticaria — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: On the 8th day, a circular swelling, the size of a baseball, with redness, warmth, itchiness, and pain on pressure suddenly appeared about 2-3 inches below the injection site. There were also diffuse urticaria around it. This lasted for about 4 days. · Healthcare visit (other): I reported in my patient portal. Doctor has not replied.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-10
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-17
Dose 2 — Moderna
2021-03-24
Survey response — day 7, dose 2
MedDRA: Arthralgia, Chills, Cough, Headache, Myalgia, Pyrexia, Self-medication — Feeling: Good · Site: Pain, Redness, Swelling · Be unable to do your normal daily activities

Free text: I experienced slight fever, chilly sensation, mild headache, moderate joint and muscle pains, and dry incessant cough 8 hrs after my 2nd dose. I had to take Tylenol 500 mg every 4 hours x 4 doses until the next day. After which all symptoms disappeared except for the dry continuous cough. On the 3rd day, the cough suddenly just stopped! No symptoms ever since.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — day 14, dose 2
MedDRA: Dizziness, Headache — Feeling: Good

Free text: On and off mild headache and transient dizziness or wooziness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-22
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-28
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-16
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-15
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-29
Call 1 — Left Voicemail
2021-10-25
Dose 3 — Moderna
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling, Itching · None

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-10-30
Survey response — days 1–6 daily, dose 3
MedDRA: Abdominal pain upper, Hyperchlorhydria — Feeling: Good · Site: Pain · Abdominal pain

Free text: Epigastric pain, like hyperacidity.

MedDRA releases: 2024-11 · check-in free text available
2021-10-31
Survey response — days 1–6 daily, dose 3
MedDRA: Abdominal pain upper — Feeling: Good · Abdominal pain

Free text: Still with occ epig pain.

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Health check-in — day 7, dose 3
Feeling: Good · Abdominal pain

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-10-29
Dose 4 — Moderna
2022-10-30
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-10-31
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2022-11-01
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2022-11-02
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2022-11-03
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2022-11-04
Survey response — days 1–6 daily, dose 4
MedDRA: Injection site pain, Injection site pruritus — Feeling: Good · Site: Pain, Itching · Rash, not including the immediate area around the injection site

Free text: I noticed that the pain upon touching and the itchiness is not at the exact injection site but about 2-3 inches below the injection.

MedDRA releases: 2024-11 · check-in free text available
2022-11-12
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-11-19
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-17	Moderna
2	2021-03-17	Moderna
3	2021-10-25	Moderna	No
4	2022-10-29	Moderna	No

Call center

1 call center case

1 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 4 — day 0, dose 1

2021-02-17

Systemic reaction (other): Some itchiness on a small area of the right palm

Release 4 — days 1–6 daily, dose 1

2021-02-18

Systemic reaction (other): Epigastric pain and 1 episode of soft (not watery) stools

2021-02-21

Systemic reaction (other): Epigastric pain

2021-02-22

Systemic reaction (other): Epigastric pain, but could be related to spicy food I ate.

Release 4 — day 14, dose 1

2021-03-03

Symptoms: On the 8th day, a circular swelling, the size of a baseball, with redness, warmth, itchiness, and pain on pressure suddenly appeared about 2-3 inches below the injection site. There were also diffuse urticaria around it. This lasted for about 4 days. cut off by CDC

Healthcare visit (other): I reported in my patient portal. Doctor has not replied.

Release 6 — day 7, dose 2

2021-03-24

Systemic reaction (other): I experienced slight fever, chilly sensation, mild headache, moderate joint and muscle pains, and dry incessant cough 8 hrs after my 2nd dose. I had to take Tylenol 500 mg every 4 hours x 4 doses until the next day. After which all symptoms disappeared except for the dry continuous cough. On the 3rd day, the cough suddenly just stopped! No symptoms ever since.

Release 6 — day 14, dose 2

2021-03-31

Symptoms: On and off mild headache and transient dizziness or wooziness.

Release 10 — days 1–6 daily, dose 3

2021-10-30

Systemic reaction (other): Epigastric pain, like hyperacidity.

2021-10-31

Systemic reaction (other): Still with occ epig pain.

Release 12 — days 1–6 daily, dose 4

2022-11-04

Systemic reaction (other): I noticed that the pain upon touching and the itchiness is not at the exact injection site but about 2-3 inches below the injection.

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	Medical counselling	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Urticaria	✓	✓	✓
SRO	Abdominal pain upper	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Faeces soft	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hyperchlorhydria	·	·	✓
SRO	Injection site pain	·	·	✓
SRO	Injection site pruritus	·	·	✓
SRO	Myalgia	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Self-medication	✓	✓	✓

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