3RQ-29279-19097

4 vaccinations 16 coded responses 38 check-ins 14 free-text entries 0 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 551 / MN
Registered: 2021-01-29

Relationship: Self
Race: Multiracial
Ethnicity: 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

2021-01-29
Registered in v-safe
2021-01-29
Dose 1 — Moderna
2021-01-29
Survey response — day 0, dose 1
MedDRA: Confusional state, Hypoaesthesia, Pruritus — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Face itches, hands feel somewhat numb, confusion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

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

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · Nausea

Adult check-in
2021-02-02
Survey response — days 1–6 daily, dose 1
MedDRA: Confusional state, Disorientation, Memory impairment — Feeling: Good

Free text: When I first got the shot I felt very disoriented and confused. Through these past days Ive gotten better. Even though I feel much better now, I still have a bit of hard time remembering things. It doesnt prevent me from doing things overall, Im just not as efficient yet.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-02-05
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-12
Survey response — day 14, dose 1
MedDRA: Dizziness, Nausea — Feeling: Fair

Free text: Nauseated, felt like I was going to pass out. Lasted 30-40 minutes. Happened only once in the morning.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-27
Dose 2 — Moderna
2021-02-27
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Pain, Pharyngeal swelling — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: I feel like my throat is swollen and have mild pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Fair · Site: Pain, Redness, Itching · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Had a hard time breathing right throughout the day.

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

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Headache · Be unable to do your normal daily activities

Adult check-in
2021-03-07
Health check-in — day 7, dose 2
Feeling: Good · Site: Redness, Itching · Headache

Adult check-in
2021-03-15
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-20
Survey response — day 21, dose 2
MedDRA: Headache, Pain in extremity — Feeling: Fair

Free text: Random stabbing pain on the left arm, not where I got my Covid shot. Headache, only in the morning the past 2 days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — day 28, dose 2
MedDRA: Pain in extremity — Feeling: Fair

Free text: Random stabbing pain on my left arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — day 35, dose 2
MedDRA: Dermatitis acneiform, Rash macular — Feeling: Good

Free text: Additional rash by my wrist on the arm where I got my COVID shot, I also have dark spots on my hand on that same arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-29
Survey response — 3 months, dose 2
MedDRA: Rash — Feeling: Good

Free text: Rash on arm site and same side leg

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-30
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-12-21
Dose 3 — Moderna
2022-02-27
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-11-08
Dose 4 — Pfizer-BioNTech
2022-11-09
Survey response — days 1–6 daily, dose 4
MedDRA: Disorientation, Paraesthesia — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work or attend school

Free text: Disoriented, tingling on my right foot while walking

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, Redness, Swelling · Headache, Fatigue or tiredness

Adult check-in
2022-11-11
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache

Adult check-in
2022-11-12
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-11-13
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-14
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Itching · Headache · Be unable to do your normal daily activities

Adult check-in
2022-11-15
Health check-in — day 7, dose 4
Feeling: Fair · Headache

Adult check-in
2022-11-22
Survey response — day 14, dose 4
MedDRA: Rash — Feeling: Fair

Free text: New rash on my arms and legs

MedDRA releases: 2024-11 · check-in free text available
2022-12-06
Survey response — day 28, dose 4
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Tired every day for the past week

MedDRA releases: 2024-11 · check-in free text available
2022-12-13
Survey response — day 35, dose 4
MedDRA: Rash — Feeling: Good

Free text: Continuing to develop rashes all over my body :(

MedDRA releases: 2024-11 · check-in free text available
2022-12-20
Survey response — day 42, dose 4
MedDRA: Rash, Urinary tract infection — Feeling: Fair · Be unable to do your normal daily activities

Free text: Urinary tract infection, rash all over my body continues

MedDRA releases: 2024-11 · check-in free text available
2023-02-07
Survey response — 3 months, dose 4
MedDRA: Rash — Feeling: Good

MedDRA releases: 2024-11
2023-05-09
Survey response — 6 months, dose 4
MedDRA: Rash — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-29	Moderna
2	2021-02-27	Moderna
3	2021-12-21	Moderna	No
4	2022-11-08	Pfizer-BioNTech	No

Free text

Release 3 — day 0, dose 1

2021-01-29

Systemic reaction (other): Face itches, hands feel somewhat numb, confusion

Release 3 — days 1–6 daily, dose 1

2021-02-02

Systemic reaction (other): When I first got the shot I felt very disoriented and confused. Through these past days Ive gotten better. Even though I feel much better now, I still have a bit of hard time remembering things. It doesnt prevent me from doing things overall, Im just not as efficient yet.

Release 4 — day 14, dose 1

2021-02-12

Symptoms: Nauseated, felt like I was going to pass out. Lasted 30-40 minutes. Happened only once in the morning.

Release 4 — days 1–6 daily, dose 2

2021-02-28

Systemic reaction (other): I feel like my throat is swollen and have mild pain.

2021-03-02

Systemic reaction (other): Had a hard time breathing right throughout the day.

Release 6 — day 21, dose 2

2021-03-20

Symptoms: Random stabbing pain on the left arm, not where I got my Covid shot. Headache, only in the morning the past 2 days.

Release 6 — day 28, dose 2

2021-03-27

Symptoms: Random stabbing pain on my left arm.

Release 6 — day 35, dose 2

2021-04-03

Symptoms: Additional rash by my wrist on the arm where I got my COVID shot, I also have dark spots on my hand on that same arm.

Release 8 — 3 months, dose 2

2021-05-29

Symptoms: Rash on arm site and same side leg

Release 12 — days 1–6 daily, dose 4

2022-11-09

Systemic reaction (other): Disoriented, tingling on my right foot while walking

Release 12 — day 14, dose 4

2022-11-22

Symptoms: New rash on my arms and legs

Release 12 — day 28, dose 4

2022-12-06

Symptoms: Tired every day for the past week

Release 12 — day 35, dose 4

2022-12-13

Symptoms: Continuing to develop rashes all over my body :(

Release 12 — day 42, dose 4

2022-12-20

Symptoms: Urinary tract infection, rash all over my body continues

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	Dermatitis acneiform	✓	✓	✓
SD	Dizziness	✓	·	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash macular	✓	✓	✓
SD	Urinary tract infection	·	·	✓
SRO	Confusional state	✓	✓	✓
SRO	Disorientation	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Memory impairment	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Paraesthesia	·	·	✓
SRO	Pharyngeal swelling	✓	✓	✓
SRO	Pruritus	✓	✓	✓

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