3RB-19707-12678

2 vaccinations 8 coded responses 26 check-ins 8 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 198 / DE
Registered: 2021-02-26

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-02-26
Registered in v-safe
2021-02-26
Dose 1 — Moderna
2021-02-26
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Good

Free text: Slight dizziness- intermittent/occaisional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: fatigue mild

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · None

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Chills, Headache, Joint pains · Be unable to do your normal daily activities

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-12
Survey response — day 14, dose 1
MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Joint pain right knee(no injury associated)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-26
Dose 2 — Moderna
2021-03-26
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: New area of rash erupted on inner wrist; older post vaccine chest rash stll there

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — day 7, dose 2
MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Chest rash resolving

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

Adult check-in
2021-04-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-23
Survey response — day 28, dose 2
MedDRA: Abdominal discomfort, Myalgia, Pre-existing disease, Rhinorrhoea — Feeling: Fair

Free text: Allergenic in nature, runny nose , lower GI distress x 3 days, muscle aches, no fever

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-25
Survey response — 3 months, dose 2
MedDRA: Purpura — Feeling: Good

Free text: Spontaneous appearance purpura 4-5 spots congregated near each other right thigh. Came and went w/in 2 week period-- odd.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-24
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-03-28
Survey response — 12 months, dose 2
MedDRA: Brain fog, Cough, Fatigue, Nausea, Pharyngeal swelling, Somnolence — Feeling: Fair · Be unable to do your normal daily activities

Free text: This month: Sudden onset cough preceeded by throat swelling(short duration); nausea ; week worth extreme fatigue and need to sleep. Mental fog 2-3 days. Better after 2 wks. PCR negative day 5.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-26	Moderna
2	2021-03-26	Moderna

Free text

Release 4 — day 0, dose 1

2021-02-26

Systemic reaction (other): Slight dizziness- intermittent/occaisional

Release 4 — days 1–6 daily, dose 1

2021-02-27

Systemic reaction (other): fatigue mild

Release 5 — day 14, dose 1

2021-03-12

Symptoms: Joint pain right knee(no injury associated)

Release 6 — days 1–6 daily, dose 2

2021-04-01

Systemic reaction (other): New area of rash erupted on inner wrist; older post vaccine chest rash stll there

Release 6 — day 7, dose 2

2021-04-02

Systemic reaction (other): Chest rash resolving

Release 7 — day 28, dose 2

2021-04-23

Symptoms: Allergenic in nature, runny nose , lower GI distress x 3 days, muscle aches, no fever

Release 9 — 3 months, dose 2

2021-06-25

Symptoms: Spontaneous appearance purpura 4-5 spots congregated near each other right thigh. Came and went w/in 2 week period-- odd.

Release 11 — 12 months, dose 2

2022-03-28

Symptoms: This month: Sudden onset cough preceeded by throat swelling(short duration); nausea ; week worth extreme fatigue and need to sleep. Mental fog 2-3 days. Better after 2 wks. PCR negative day 5.

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	Abdominal discomfort	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Brain fog	·	·	✓
SD	Cough	·	·	✓
SD	Fatigue	·	·	✓
SD	Myalgia	✓	✓	✓
SD	Nausea	·	·	✓
SD	Pharyngeal swelling	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Purpura	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Somnolence	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Rash	✓	✓	✓

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