3KW-32264-09255

2 vaccinations 8 coded responses 23 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 957 / CA
Registered: 2021-02-10

Relationship: Self
Race: White
Ethnicity: N/A

Timeline

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

2021-02-09
Dose 1 — Moderna
2021-02-10
Registered in v-safe
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · None

Adult check-in
2021-02-11
Survey response — days 1–6 daily, dose 1
MedDRA: Exposure to SARS-CoV-2 — Feeling: Fair · Site: Pain, Redness, Swelling, Itching

Free text: Was exposed to Covid-19 at work the same day I received the vaccine. Received vaccine first, was exposed later that day.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness · Fatigue or tiredness, Nausea

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-15
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia — Feeling: Good · Site: Redness · Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: Numbness in left arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Health check-in — day 7, dose 1
Feeling: Fair · Site: Redness · Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-02-23
Survey response — day 14, dose 1
MedDRA: Headache, Injection site rash, Injection site vesicles — Feeling: Good

Free text: Small blisters and red bumps around injection site. Starting to go away. Frequent headaches.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Dose 2 — Moderna
2021-03-09
Health check-in — day 0, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · 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
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia, Impaired work ability, Malaise, Paraesthesia, Vaccine positive rechallenge — Feeling: Good · Site: Swelling

Free text: I missed a day of reporting because I was pretty ill. Every symptom above except vomiting, diarrhea and rash. I missed a day of work. Sorry to report it on the wrong day but I was rather ill. Also, I had tingling and numbness in the injection arm. I had the same with my first shot. It is vaccine related because I had them do my right arm this time, I did my left arm with the first injection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-03-16
Survey response — day 7, dose 2
MedDRA: Chest discomfort — Feeling: Good · Site: Redness, Swelling · Headache

Free text: Tightness in chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-08
Survey response — day 28, dose 2
MedDRA: Energy increased, Headache — Feeling: Good

Free text: Very low energy, sporadic headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-20
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-08
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-09
Survey response — 6 months, dose 2
MedDRA: Alopecia, Arthralgia, Chest pain, Fatigue, Oedema, Telemedicine — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Achy joints, fatigue, hair loss, edema, occasional chest pain · Healthcare visit (other): Video appt, recommended ER because I moved, edema subsided more next day so didnt go

MedDRA releases: 2024-11 · check-in free text available
2021-09-09
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)
2021-09-14
Call 1 — Left Voicemail
2022-03-09
Survey response — 12 months, dose 2
MedDRA: Brain fog, Fatigue, Headache, Oedema, Office visit, Pre-existing disease — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Edema. Significant Brain fog, tired, daily headaches. However, these symptoms appear to be due to long covid. · Healthcare visit (other): Routine dr appt

MedDRA releases: 2024-11 · check-in free text available
2022-03-09
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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-03-10
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-09	Moderna
2	2021-03-09	Moderna

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-11

Systemic reaction (other): Was exposed to Covid-19 at work the same day I received the vaccine. Received vaccine first, was exposed later that day.

2021-02-15

Systemic reaction (other): Numbness in left arm

Release 4 — day 14, dose 1

2021-02-23

Symptoms: Small blisters and red bumps around injection site. Starting to go away. Frequent headaches.

Release 5 — days 1–6 daily, dose 2

2021-03-14

Systemic reaction (other): I missed a day of reporting because I was pretty ill. Every symptom above except vomiting, diarrhea and rash. I missed a day of work. Sorry to report it on the wrong day but I was rather ill. Also, I had tingling and numbness in the injection arm. I had the same with my first shot. It is vaccine related because I had them do my right arm this time, I did my left arm with the first injection.

Release 5 — day 7, dose 2

2021-03-16

Systemic reaction (other): Tightness in chest

Release 7 — day 28, dose 2

2021-04-08

Symptoms: Very low energy, sporadic headaches

Release 9 — 6 months, dose 2

2021-09-09

Symptoms: Achy joints, fatigue, hair loss, edema, occasional chest pain

Healthcare visit (other): Video appt, recommended ER because I moved, edema subsided more next day so didnt go

Release 11 — 12 months, dose 2

2022-03-09

Symptoms: Edema. Significant Brain fog, tired, daily headaches. However, these symptoms appear to be due to long covid.

Healthcare visit (other): Routine dr appt

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	Oedema	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	Telemedicine	·	·	✓
SD	Alopecia	·	·	✓
SD	Arthralgia	·	·	✓
SD	Brain fog	·	·	✓
SD	Chest pain	·	·	✓
SD	Energy increased	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Injection site vesicles	✓	✓	✓
SD	Oedema	·	·	✓
SD	Pre-existing disease	·	·	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Exposure to SARS-CoV-2	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Impaired work ability	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Vaccine positive rechallenge	✓	✓	✓

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