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3M5-16736-09622

4 vaccinations 22 coded responses 52 check-ins 22 free-text entries 0 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
617 / IL
Registered
2021-03-10
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-09
    Dose 1 — Moderna
  2. 2021-03-10
    Registered in v-safe
  3. 2021-03-10
    Survey response — days 1–6 daily, dose 1
    MedDRA: Insomnia — Feeling: Fair · Site: Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Did not sleep well last night; just generally don't feel well.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-11
    Survey response — days 1–6 daily, dose 1
    MedDRA: Unevaluable event — Feeling: Good · Site: Pain
    Free text: Another bad night. Slept maybe a couple of hours. Odd.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-12
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-03-13
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Fatigue or tiredness
    Adult check-in
  7. 2021-03-14
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · None
    Adult check-in
  8. 2021-03-15
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Fatigue or tiredness
    Adult check-in
  9. 2021-03-16
    Survey response — day 7, dose 1
    MedDRA: Fatigue, Hypogammaglobulinaemia, Pre-existing disease — Feeling: Fair · Fatigue or tiredness
    Free text: You might want to know I have had a health problem since 1988. Fatigue is part of that. Also, I have hypogammaglobulinemia and my body no longer makes antibodies to pneumococca.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-03-23
    Survey response — day 14, dose 1
    MedDRA: Asthenia, Dizziness, Fatigue, Feeling cold, Headache, Malaise — Feeling: Poor
    Free text: Headache today, more tired, sort of sick feeling (thought that was something I ate, maybe), weak, some dizziness, feel cold
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-03-30
    Health check-in — day 21, dose 1
    Feeling: Fair
    Adult check-in
  12. 2021-04-06
    Health check-in — day 28, dose 1
    Feeling: Fair
    Adult check-in
  13. 2021-04-08
    Dose 2 — Moderna
  14. 2021-04-09
    Survey response — days 1–6 daily, dose 2
    MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Sore throat
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-04-10
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pyrexia — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: Definitely fever in injection area. Yesterday as well.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-04-11
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site erythema, Injection site warmth, Pain, Urticaria — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: Apparently had the "vaccine arm" already but didn't realize until last night; there is still fever in the area near the injection. Red welts seem to be growing. Felt generally feverish last night but not so far today. Oddly, these injections seem to bring back "tennis elbow" pain from injury I had in 1999. That's the most bothersome; really hurts.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-04-12
    Survey response — days 1–6 daily, dose 2
    MedDRA: Asthenia, Feeling hot, Tenderness, Tremor, Urticaria — Feeling: Fair · Site: Pain, Redness, Itching · Joint pains, Fatigue or tiredness
    Free text: Arm remains feverish; welted areas tender to the touch; had an episode of being weak and shaky
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-04-13
    Survey response — days 1–6 daily, dose 2
    MedDRA: Arthralgia, Limb discomfort, Malaise — Feeling: Fair · Site: Redness, Itching · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Free text: pain in elbow subsided; other arm symptoms improved also; have felt on the verge of really being ill
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  19. 2021-04-14
    Survey response — days 1–6 daily, dose 2
    MedDRA: Malaise, Oropharyngeal pain — Feeling: Fair · Site: Redness · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: A bit of a sore throat; just don't feel well.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-04-15
    Survey response — day 7, dose 2
    MedDRA: Malaise — Feeling: Poor · Site: Redness · Fever · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Again, just really don't feel well, like I should have spent the day in bed.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-04-22
    Health check-in — day 14, dose 2
    Feeling: Fair
    Adult check-in
  22. 2021-04-29
    Health check-in — day 21, dose 2
    Feeling: Fair
    Adult check-in
  23. 2021-05-06
    Health check-in — day 28, dose 2
    Feeling: Fair
    Adult check-in
  24. 2021-05-13
    Health check-in — day 35, dose 2
    Feeling: Fair
    Adult check-in
  25. 2021-05-20
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in
  26. 2021-07-09
    Survey response — 3 months, dose 2
    MedDRA: Dry eye, Eye irritation, Heat exhaustion, Lung disorder, Malaise, Skin swelling — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Heat exhaustion, I think. Puffed up like a puffer fish. lol Flooding here took out the AC for six days. Better now. I also had general unwellness, extreme dryness and burning eyes while trying Symbicort for continuing lung problems.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  27. 2021-10-07
    Survey response — 6 months, dose 2
    MedDRA: Breast pain, Discomfort, Urethral pain — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Breast pain Fullness under arm Urethral pain
    MedDRA releases: 2024-11 · check-in free text available
  28. 2021-12-22
    Dose 3 — Pfizer-BioNTech
  29. 2021-12-23
    Survey response — days 1–6 daily, dose 3
    MedDRA: Axillary pain, Breast pain, Feeling cold — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Free text: Pain around breasts and armpits; couldn't get warm last night.
    MedDRA releases: 2024-11 · check-in free text available
  30. 2021-12-24
    Survey response — days 1–6 daily, dose 3
    MedDRA: Asthenia, Decreased appetite — Feeling: Poor · Site: Pain, Itching · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Continued significant weakness; inappetence
    MedDRA releases: 2024-11 · check-in free text available
  31. 2021-12-25
    Survey response — days 1–6 daily, dose 3
    MedDRA: Cough — Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Cough
    MedDRA releases: 2024-11 · check-in free text available
  32. 2021-12-26
    Survey response — days 1–6 daily, dose 3
    MedDRA: Cough — Feeling: Fair · Site: Pain · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities
    Free text: Cough
    MedDRA releases: 2024-11 · check-in free text available
  33. 2021-12-27
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  34. 2021-12-28
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  35. 2021-12-29
    Health check-in — day 7, dose 3
    Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities
    Adult check-in
  36. 2022-01-05
    Health check-in — day 14, dose 3
    Feeling: Fair
    Adult check-in
  37. 2022-01-12
    Health check-in — day 21, dose 3
    Feeling: Fair
    Adult check-in
  38. 2022-01-19
    Health check-in — day 28, dose 3
    Feeling: Fair
    Adult check-in
  39. 2022-01-26
    Survey response — day 35, dose 3
    MedDRA: Headache — Feeling: Fair
    Free text: Nearly constant headache for about a week, mostly in my forehead.
    MedDRA releases: 2024-11 · check-in free text available
  40. 2022-02-02
    Health check-in — day 42, dose 3
    Feeling: Fair
    Adult check-in
  41. 2022-03-23
    Health check-in — 3 months, dose 3
    Feeling: Fair
    Adult check-in
  42. 2022-06-22
    Health check-in — 6 months, dose 3
    Feeling: Fair
    Adult check-in
  43. 2022-11-10
    Dose 4 — Moderna
  44. 2022-11-11
    Survey response — days 1–6 daily, dose 4
    MedDRA: Asthenia, Palpitations — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Free text: Palpitations, weakness
    MedDRA releases: 2024-11 · check-in free text available
  45. 2022-11-12
    Survey response — days 1–6 daily, dose 4
    MedDRA: Asthenia — Feeling: Poor · Site: Pain, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Weakness
    MedDRA releases: 2024-11 · check-in free text available
  46. 2022-11-13
    Health check-in — days 1–6 daily, dose 4
    Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness
    Adult check-in
  47. 2022-11-14
    Health check-in — days 1–6 daily, dose 4
    Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness
    Adult check-in
  48. 2022-11-15
    Health check-in — days 1–6 daily, dose 4
    Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness
    Adult check-in
  49. 2022-11-16
    Health check-in — days 1–6 daily, dose 4
    Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness
    Adult check-in
  50. 2022-11-17
    Health check-in — day 7, dose 4
    Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness
    Adult check-in
  51. 2022-11-24
    Health check-in — day 14, dose 4
    Feeling: Poor
    Adult check-in
  52. 2022-12-01
    Survey response — day 21, dose 4
    MedDRA: Chills, Influenza like illness — Feeling: Good · Be unable to do your normal daily activities
    Free text: Intermittent chills Fluish feeling
    MedDRA releases: 2024-11 · check-in free text available
  53. 2022-12-08
    Health check-in — day 28, dose 4
    Feeling: Fair
    Adult check-in
  54. 2022-12-15
    Survey response — day 35, dose 4
    MedDRA: Cough, Fatigue, Loss of personal independence in daily activities, Pyrexia — Feeling: Poor
    Free text: Low fever, mild chest cough, fatigue (Curtailed planned activities.)
    MedDRA releases: 2024-11 · check-in free text available
  55. 2022-12-22
    Health check-in — day 42, dose 4
    Feeling: Fair
    Adult check-in
  56. 2023-02-10
    Health check-in — 3 months, dose 4
    Feeling: Fair
    Adult check-in
  57. 2023-05-12
    Health check-in — 6 months, dose 4
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-09Moderna
22021-04-08Moderna
32021-12-22Pfizer-BioNTech No
42022-11-10Moderna No

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-10

Systemic reaction (other): Did not sleep well last night; just generally don't feel well.

2021-03-11

Systemic reaction (other): Another bad night. Slept maybe a couple of hours. Odd.

Release 5 — day 7, dose 1

2021-03-16

Systemic reaction (other): You might want to know I have had a health problem since 1988. Fatigue is part of that. Also, I have hypogammaglobulinemia and my body no longer makes antibodies to pneumococca.

Release 6 — day 14, dose 1

2021-03-23

Symptoms: Headache today, more tired, sort of sick feeling (thought that was something I ate, maybe), weak, some dizziness, feel cold

Release 7 — days 1–6 daily, dose 2

2021-04-09

Systemic reaction (other): Sore throat

2021-04-10

Systemic reaction (other): Definitely fever in injection area. Yesterday as well.

2021-04-11

Systemic reaction (other): Apparently had the "vaccine arm" already but didn't realize until last night; there is still fever in the area near the injection. Red welts seem to be growing. Felt generally feverish last night but not so far today. Oddly, these injections seem to bring back "tennis elbow" pain from injury I had in 1999. That's the most bothersome; really hurts.

2021-04-12

Systemic reaction (other): Arm remains feverish; welted areas tender to the touch; had an episode of being weak and shaky

2021-04-13

Systemic reaction (other): pain in elbow subsided; other arm symptoms improved also; have felt on the verge of really being ill

2021-04-14

Systemic reaction (other): A bit of a sore throat; just don't feel well.

Release 7 — day 7, dose 2

2021-04-15

Systemic reaction (other): Again, just really don't feel well, like I should have spent the day in bed.

Release 9 — 3 months, dose 2

2021-07-09

Symptoms: Heat exhaustion, I think. Puffed up like a puffer fish. lol Flooding here took out the AC for six days. Better now. I also had general unwellness, extreme dryness and burning eyes while trying Symbicort for continuing lung problems.

Release 10 — 6 months, dose 2

2021-10-07

Symptoms: Breast pain Fullness under arm Urethral pain

Release 10 — days 1–6 daily, dose 3

2021-12-23

Systemic reaction (other): Pain around breasts and armpits; couldn't get warm last night.

2021-12-24

Systemic reaction (other): Continued significant weakness; inappetence

2021-12-25

Systemic reaction (other): Cough

2021-12-26

Systemic reaction (other): Cough

Release 11 — day 35, dose 3

2022-01-26

Symptoms: Nearly constant headache for about a week, mostly in my forehead.

Release 12 — days 1–6 daily, dose 4

2022-11-11

Systemic reaction (other): Palpitations, weakness

2022-11-12

Systemic reaction (other): Weakness

Release 12 — day 21, dose 4

2022-12-01

Symptoms: Intermittent chills Fluish feeling

Release 12 — day 35, dose 4

2022-12-15

Symptoms: Low fever, mild chest cough, fatigue (Curtailed planned activities.)

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
SDAsthenia ✓ ✓ ✓
SDBreast pain · · ✓
SDChills · · ✓
SDCough · · ✓
SDDiscomfort · · ✓
SDDizziness ✓ ✓ ✓
SDDry eye ✓ ✓ ✓
SDEye irritation ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDFeeling cold ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDHeat exhaustion ✓ ✓ ✓
SDInfluenza like illness · · ✓
SDLoss of personal independence in daily activities · · ✓
SDLung disorder ✓ ✓ ✓
SDMalaise ✓ ✓ ✓
SDPyrexia · · ✓
SDSkin swelling ✓ ✓ ✓
SDUrethral pain · · ✓
SROArthralgia ✓ ✓ ✓
SROAsthenia ✓ ✓ ✓
SROAxillary pain · · ✓
SROBreast pain · · ✓
SROCough · · ✓
SRODecreased appetite · · ✓
SROFatigue ✓ ✓ ○
SROFeeling cold · · ✓
SROFeeling hot ✓ ✓ ✓
SROHypogammaglobulinaemia ✓ ✓ ○
SROInjection site erythema ✓ ✓ ✓
SROInjection site warmth ✓ ✓ ✓
SROInsomnia ✓ ✓ ✓
SROLimb discomfort ✓ ✓ ✓
SROMalaise ✓ ✓ ✓
SROOropharyngeal pain ✓ ✓ ✓
SROPain ✓ ✓ ✓
SROPalpitations · · ✓
SROPre-existing disease · · ✓
SROPyrexia ✓ ✓ ✓
SROTenderness ✓ ✓ ✓
SROTremor ✓ ✓ ✓
SROUnevaluable event ✓ ✓ ✓
SROUrticaria ✓ ✓ ✓

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

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