3UH-22965-93494

3 vaccinations 12 coded responses 34 check-ins 12 free-text entries 0 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 967 / HI
Registered: 2021-03-24

Relationship: Self
Race: Multiracial
Ethnicity: N/A

Registered dependents

8NQ-24122-79730 Child or adolescent in my care · Female · 2021-12-05

M32-30488-94516 Child or adolescent in my care · Female · 2021-12-05

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-03-24
Registered in v-safe
2021-03-24
Dose 1 — Moderna
2021-03-24
Survey response — day 0, dose 1
MedDRA: Paranasal sinus discomfort — Feeling: Good · Site: Pain

Free text: A slight sinus pressure earlier

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-07
Survey response — day 14, dose 1
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — day 21, dose 1
MedDRA: Dizziness — Feeling: Fair · Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Dose 2 — Moderna
2021-04-21
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · None

Adult check-in
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite, Thirst — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: No appetite, excessive thirst

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-28
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-05
Survey response — day 14, dose 2
MedDRA: Fatigue, Productive cough — Feeling: Fair · Be unable to do your normal daily activities

Free text: A little extra phlegm, extremely tired.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Survey response — day 21, dose 2
MedDRA: Feeling jittery, Tremor — Feeling: Fair

Free text: Arms jittery/shaky every so often.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Survey response — day 28, dose 2
MedDRA: Fatigue — Feeling: Fair

Free text: Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Survey response — day 35, dose 2
MedDRA: Rash, Rash pruritic — Feeling: Fair

Free text: Rash/bumps on my feet (itchiness).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-05
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-25
Survey response — 3 months, dose 2
MedDRA: Headache, Pain in extremity, Skin disorder — Feeling: Fair · Be unable to do your normal daily activities

Free text: Pain in head. Pain in hand. Increased skin issues.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-20
Survey response — 6 months, dose 2
MedDRA: Dizziness, Headache, Nausea, Neck pain, Neuralgia, Pain in extremity — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Localized pain in neck/head/nerve. Pain in hand/fingers. Dizziness/nauseous/light-headed.

MedDRA releases: 2024-11 · check-in free text available
2021-12-04
Dose 3 — Moderna
2021-12-04
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-12-06
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Nausea

Adult check-in
2021-12-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-12-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-12-09
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-12-15
Health check-in — day 7, dose 3
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-27
Survey response — day 21, dose 3
MedDRA: Anxiety, Headache, Nausea — Feeling: Poor · Be unable to do your normal daily activities

Free text: Nauseous, queasy, anxious, headache.

MedDRA releases: 2024-11 · check-in free text available
2022-01-18
Survey response — day 42, dose 3
MedDRA: Menstruation irregular — Feeling: Fair

Free text: Started bleeding (menstrual) earlier than anticipated. Approximately 2 weeks after I finished my last period.

MedDRA releases: 2024-11 · check-in free text available
2022-03-07
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-24	Moderna
2	2021-04-21	Moderna
3	2021-12-04	Moderna	No

Free text

Release 6 — day 0, dose 1

2021-03-24

Systemic reaction (other): A slight sinus pressure earlier

Release 7 — day 14, dose 1

2021-04-07

Symptoms: Fatigue

Release 7 — day 21, dose 1

2021-04-16

Symptoms: Dizziness

Release 7 — days 1–6 daily, dose 2

2021-04-22

Systemic reaction (other): No appetite, excessive thirst

Release 8 — day 14, dose 2

2021-05-05

Symptoms: A little extra phlegm, extremely tired.

Release 8 — day 21, dose 2

2021-05-12

Symptoms: Arms jittery/shaky every so often.

Release 8 — day 28, dose 2

2021-05-19

Symptoms: Fatigue

Release 8 — day 35, dose 2

2021-05-26

Symptoms: Rash/bumps on my feet (itchiness).

Release 9 — 3 months, dose 2

2021-07-25

Symptoms: Pain in head. Pain in hand. Increased skin issues.

Release 10 — 6 months, dose 2

2021-10-20

Symptoms: Localized pain in neck/head/nerve. Pain in hand/fingers. Dizziness/nauseous/light-headed.

Release 10 — day 21, dose 3

2021-12-27

Symptoms: Nauseous, queasy, anxious, headache.

Release 10 — day 42, dose 3

2022-01-18

Symptoms: Started bleeding (menstrual) earlier than anticipated. Approximately 2 weeks after I finished my last period.

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	Anxiety	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling jittery	✓	✓	✓
SD	Headache	✓	·	✓
SD	Menstruation irregular	·	·	✓
SD	Nausea	·	·	✓
SD	Neck pain	·	·	✓
SD	Neuralgia	·	·	✓
SD	Pain in extremity	✓	·	✓
SD	Productive cough	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SD	Skin disorder	✓	·	✓
SD	Tremor	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Paranasal sinus discomfort	✓	✓	✓
SRO	Thirst	✓	✓	✓

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