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3FV-28195-60465

4 vaccinations 9 coded responses 47 check-ins 8 free-text entries 2 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
224 / VA
Registered
2021-02-05
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-04
    Dose 1 — Moderna
  2. 2021-02-05
    Registered in v-safe
  3. 2021-02-05
    Survey response — days 1–6 daily, dose 1
    MedDRA: Headache, Myalgia, Nausea, Pain in extremity — Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness
    Free text: Yesterday about 3 hours after shot had mild nausea along with HA , mild muscle aches upper body and mild arm soreness.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-02-06
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  5. 2021-02-07
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-02-08
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-02-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-02-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-02-11
    Survey response — day 7, dose 1
    MedDRA: Dizziness — Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Free text: Dizzy/lightheaded when up/moving.Volunteer Wednesday at initial Covid vaccine clinic.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-02-18
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-02-25
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-03-04
    Dose 2 — Moderna
  13. 2021-03-04
    Health check-in — day 0, dose 2
    Feeling: Good · None
    Adult check-in
  14. 2021-03-05
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  15. 2021-03-06
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  16. 2021-03-07
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site swelling — Feeling: Good · Site: Pain, Swelling
    Free text: Swelling is underneath injection site(below) 2X2
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-03-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Swelling · None
    Adult check-in
  18. 2021-03-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Swelling · None
    Adult check-in
  19. 2021-03-10
    Survey response — days 1–6 daily, dose 2
    MedDRA: Rash, Rash erythematous — Feeling: Good · Rash, not including the immediate area around the injection site
    Free text: Red rash upper middle chest below neck.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-03-11
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  21. 2021-03-18
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-03-25
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-04-01
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-04-08
    Survey response — day 35, dose 2
    MedDRA: Dizziness, Fatigue, SARS-CoV-2 test negative, Unevaluable event, Vision blurred — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free text: Symptoms: April 2 volunteer at (b)(6). April 4 episode of dizziness,difficulty focusing,pupils dilated with fatigue and BP spike to 200/100 range. Checked in ER, CT/ekg normal, BP 170-160/90. Covid nasal swab neg. BP now 120/70(prior normal). Better · Healthcare visit (other): Concerned re:clot/stroke risk
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  25. 2021-04-08
    Report sent to call center — day 35, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  26. 2021-04-15
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-06-03
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-09-02
    Survey response — 6 months, dose 2
    MedDRA: Blood pressure decreased, Blood pressure increased, Cognitive disorder, Fatigue — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free text: Symptoms: 4/21 BP spike 200/100 Sunday am after Friday Covid testing clinic. Fatigue on Saturday. Resolved 4-5 days of slowly decrease in BP. Now on 10mg Lisinopril q day. · Healthcare visit (other): Concerned with stroke possibility since cognitive affected.
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  29. 2021-09-02
    Report sent to call center — 6 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  30. 2021-09-03
  31. 2021-10-22
    Dose 3 — Moderna
  32. 2021-10-28
    Survey response — days 1–6 daily, dose 3
    MedDRA: Erythema, Pain in extremity, Peripheral swelling — Feeling: Good · Site: Itching
    Free text: Shot-10/22, first 3 days arm swelling/reddened/medium sore.
    MedDRA releases: 2024-11 · check-in free text available
  33. 2021-10-29
    Survey response — day 7, dose 3
    MedDRA: Adverse reaction — Feeling: Good
    Free text: This really isn't accurate since my symptoms only lasted 4-5 days after the 10/22/21 booster.
    MedDRA releases: 2024-11 · check-in free text available
  34. 2021-11-05
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  35. 2021-11-12
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  36. 2021-11-19
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  37. 2021-11-26
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  38. 2021-12-03
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  39. 2022-01-21
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  40. 2022-04-23
    Dose 4 — Moderna
  41. 2022-04-24
    Health check-in — days 1–6 daily, dose 4
    Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  42. 2022-04-25
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Site: Pain · None
    Adult check-in
  43. 2022-04-26
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  44. 2022-04-27
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  45. 2022-04-28
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  46. 2022-04-29
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  47. 2022-04-30
    Health check-in — day 7, dose 4
    Feeling: Good · None
    Adult check-in
  48. 2022-05-07
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  49. 2022-05-14
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  50. 2022-05-21
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  51. 2022-05-28
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  52. 2022-06-04
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  53. 2022-07-23
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  54. 2022-10-22
    Health check-in — 6 months, dose 4
    Feeling: Good
    Adult check-in
  55. 2023-04-25
    Survey response — 12 months, dose 4
    MedDRA: Anosmia, COVID-19 — Feeling: Good
    MedDRA releases: 2024-11

Vaccinations

DoseDateManufacturerCo-administered
12021-02-04Moderna
22021-03-04Moderna
32021-10-22Moderna No
42022-04-23Moderna No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-05

Systemic reaction (other): Yesterday about 3 hours after shot had mild nausea along with HA , mild muscle aches upper body and mild arm soreness.

Release 4 — day 7, dose 1

2021-02-11

Systemic reaction (other): Dizzy/lightheaded when up/moving.Volunteer Wednesday at initial Covid vaccine clinic.

Release 5 — days 1–6 daily, dose 2

2021-03-07

Systemic reaction (other): Swelling is underneath injection site(below) 2X2

2021-03-10

Systemic reaction (other): Red rash upper middle chest below neck.

Release 7 — day 35, dose 2

2021-04-08

Symptoms: April 2 volunteer at (b)(6). April 4 episode of dizziness,difficulty focusing,pupils dilated with fatigue and BP spike to 200/100 range. Checked in ER, CT/ekg normal, BP 170-160/90. Covid nasal swab neg. BP now 120/70(prior normal). Better
Healthcare visit (other): Concerned re:clot/stroke risk
redacted (b)(6)

Release 9 — 6 months, dose 2

2021-09-02

Symptoms: 4/21 BP spike 200/100 Sunday am after Friday Covid testing clinic. Fatigue on Saturday. Resolved 4-5 days of slowly decrease in BP. Now on 10mg Lisinopril q day.
Healthcare visit (other): Concerned with stroke possibility since cognitive affected.

Release 10 — days 1–6 daily, dose 3

2021-10-28

Systemic reaction (other): Shot-10/22, first 3 days arm swelling/reddened/medium sore.

Release 10 — day 7, dose 3

2021-10-29

Systemic reaction (other): This really isn't accurate since my symptoms only lasted 4-5 days after the 10/22/21 booster.

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

FieldPreferred term2021-092023-042024-11
HCVOCognitive disorder ✓ · ✓
HCVOUnevaluable event ✓ ✓ ✓
SDAnosmia · · ✓
SDBlood pressure decreased ✓ · ✓
SDBlood pressure increased ✓ · ✓
SDCOVID-19 · · ✓
SDDizziness ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDSARS-CoV-2 test negative ✓ ✓ ✓
SDVision blurred ✓ ✓ ✓
SROAdverse reaction · · ✓
SRODizziness ✓ ✓ ✓
SROErythema · · ✓
SROHeadache ✓ ✓ ✓
SROInjection site swelling ✓ ✓ ✓
SROMyalgia ✓ ✓ ✓
SRONausea ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROPeripheral swelling · · ✓
SRORash ✓ ✓ ✓
SRORash erythematous ✓ ✓ ✓

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

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