39G-10884-19530

4 vaccinations 10 coded responses 49 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 981 / WA
Registered: 2021-01-29

Relationship: Self
Race: N/A
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-01-29
Registered in v-safe
2021-01-29
Dose 1 — Moderna
2021-01-29
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

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

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Headache, Fatigue or tiredness · Be unable to work

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-05
Health check-in — day 7, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-21
Survey response — day 21, dose 1
MedDRA: Cough, Pruritus — Feeling: Good · Be unable to work

Free text: Pruritus (generalized; long standing allergies), asthma related coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Dose 2 — Moderna
2021-02-26
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Sciatica — Feeling: Good

Free text: Left sided sciatic pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — day 7, dose 2
Feeling: Good · Fever · Headache

Adult check-in
2021-03-12
Health check-in — day 14, dose 2
Feeling: Good

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

Adult check-in
2021-03-28
Survey response — day 28, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good

Free text: Chronic GI disease flare up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-28
Survey response — 3 months, dose 2
MedDRA: Cervical radiculopathy — Feeling: Good · Be unable to work, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Cervical radiculopathy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Report sent to call center — 3 months, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-06
Dose 3 — Moderna
Co-administered: Flu
2021-12-07
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-12-10
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling, Itching · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-12-11
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-12-12
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-13
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-20
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-27
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-03
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-10
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-17
Survey response — day 42, dose 3
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good

Free text: Familial mediterranean fever flare (possibly due to concurrent trial of colchicine dose decrease)

MedDRA releases: 2024-11 · check-in free text available
2022-05-12
Call 1 — Left Voicemail
2022-06-07
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-05
Dose 4 — Pfizer-BioNTech
2022-11-06
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-11-07
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Free text: Ipsalateral (to inj site) axillary lymphadenopathy

MedDRA releases: 2024-11 · check-in free text available
2022-11-08
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain, Itching · Fatigue or tiredness

Free text: Axillary and supraclavicular lymphadenopathy ipsalateral to thoracic limb vaccine injection site. contralateral regional LNs are all normal.

MedDRA releases: 2024-11 · check-in free text available
2022-11-09
Survey response — days 1–6 daily, dose 4
MedDRA: Discomfort, Injection site bruising, Lymphadenopathy — Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activities

Free text: Bruising at site of injection. Less discomfort today associated with the axillary lymphadenopathy ipsalateral to [thoracic limb] vaccine injection site.

MedDRA releases: 2024-11 · check-in free text available
2022-11-10
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-11-11
Survey response — days 1–6 daily, dose 4
MedDRA: Injection site bruising — Feeling: Good · Headache

Free text: Bruising (resolving) at site of vaccine injection

MedDRA releases: 2024-11 · check-in free text available
2022-11-12
Health check-in — day 7, dose 4
Feeling: Fair · Headache · Be unable to do your normal daily activities

Adult check-in
2022-11-19
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-11-26
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-12-03
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-12-10
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-12-18
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-02-04
Survey response — 3 months, dose 4
MedDRA: Ear pain, Malaise, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school

MedDRA releases: 2024-11
2023-05-06
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-29	Moderna
2	2021-02-26	Moderna
3	2021-12-06	Moderna	Flu
4	2022-11-05	Pfizer-BioNTech	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 21, dose 1

2021-02-21

Symptoms: Pruritus (generalized; long standing allergies), asthma related coughing

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): Left sided sciatic pain

Release 6 — day 28, dose 2

2021-03-28

Symptoms: Chronic GI disease flare up

Release 8 — 3 months, dose 2

2021-05-28

Symptoms: Cervical radiculopathy

Release 10 — day 42, dose 3

2022-01-17

Symptoms: Familial mediterranean fever flare (possibly due to concurrent trial of colchicine dose decrease)

Release 12 — days 1–6 daily, dose 4

2022-11-07

Systemic reaction (other): Ipsalateral (to inj site) axillary lymphadenopathy

2022-11-08

Systemic reaction (other): Axillary and supraclavicular lymphadenopathy ipsalateral to thoracic limb vaccine injection site. contralateral regional LNs are all normal.

2022-11-09

Systemic reaction (other): Bruising at site of injection. Less discomfort today associated with the axillary lymphadenopathy ipsalateral to [thoracic limb] vaccine injection site.

2022-11-11

Systemic reaction (other): Bruising (resolving) at site of vaccine 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
SD	Cervical radiculopathy	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Ear pain	·	·	✓
SD	Malaise	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Discomfort	·	·	✓
SRO	Injection site bruising	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Sciatica	✓	✓	✓

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