46B-12598-27165

4 vaccinations 10 coded responses 37 check-ins 10 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 276 / NC
Registered: 2021-03-01

Relationship: Self
Race: Other
Ethnicity: N/A

Timeline

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

2021-03-01
Registered in v-safe
2021-03-01
Dose 1 — Moderna
2021-03-01
Health check-in — day 0, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

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

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

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-08
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-23
Survey response — day 21, dose 1
MedDRA: Fatigue, Headache — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Headaches and general fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Dose 2 — Moderna
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

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

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

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-04-06
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-04-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-21
Survey response — day 21, dose 2
MedDRA: Abdominal discomfort, Insomnia, Lethargy — Feeling: Fair · Be unable to do your normal daily activities

Free text: Stomach upset, lethargy, and trouble sleeping.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — day 28, dose 2
MedDRA: Pruritus, Self-medication, Urticaria — Feeling: Good

Free text: Substantial itching and hives at night- even after taking an antihistamine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Survey response — day 35, dose 2
MedDRA: Respiratory tract congestion, Sleep disorder — Feeling: Good

Free text: Sleep disruptions, congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-20
Dose 3 — Moderna
2021-09-28
Survey response — 6 months, dose 2
MedDRA: Periarthritis, Product administered at inappropriate site — Feeling: Fair

Free text: Booster in shoulder joint rather than muscle caused it to lock up a bit.

MedDRA releases: 2024-11 · check-in free text available
2021-11-21
Survey response — 3 months, dose 3
MedDRA: Rash — Feeling: Good

Free text: Rashes.

MedDRA releases: 2024-11 · check-in free text available
2022-02-24
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-04-22
Dose 4 — Moderna
2022-04-24
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Swelling · Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2022-04-25
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2022-04-26
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling · Rash, not including the immediate area around the injection site

Adult check-in
2022-04-27
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Swelling · Rash, not including the immediate area around the injection site

Adult check-in
2022-04-28
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2022-04-29
Health check-in — day 7, dose 4
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2022-05-07
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-05-15
Survey response — day 21, dose 4
MedDRA: Arthropod bite, Hypersensitivity, Urticaria — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Hives and substantial allergic reaction related to insect bites or ant stings. EpiPen and prednisone prescribed/administered.

MedDRA releases: 2024-11 · check-in free text available
2022-05-15
Report sent to call center — day 21, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-17
Call 1 — Could Not Reach Participant
2022-05-20
Survey response — day 28, dose 4
MedDRA: Hypersensitivity, Office visit, Sleep disorder — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Medication taken in response to my allergic reaction to ant sting/bites recieved Saturday, has disrupted my sleep, considerably. · Healthcare visit (other): Questions raised at previously regularly scheduled rheumatology appointment.

MedDRA releases: 2024-11 · check-in free text available
2022-05-20
Report sent to call center — day 28, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-05-20
Call 2 — Left Voicemail
2022-05-20
Callback requested for
2022-05-23
Call 3 — Left Voicemail
2022-05-23
Call 1 — Left Voicemail
2022-05-23
Call successful
Not applicable - Accidental Reporting
2022-06-06
Survey response — day 42, dose 4
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good

Free text: Continue to have periodic hives. They seem to be somewhat more frequent this year than last, though they've always occurred.

MedDRA releases: 2024-11 · check-in free text available
2022-07-23
Survey response — 3 months, dose 4
MedDRA: Sinusitis, Skin disorder — Feeling: Good

Free text: A dermatological issue on my lip, and a short sinus infection.

MedDRA releases: 2024-11 · check-in free text available
2022-10-21
Health check-in — 6 months, dose 4
Feeling: Poor

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-01	Moderna
2	2021-03-30	Moderna
3	2021-08-20	Moderna	No
4	2022-04-22	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 6 — day 21, dose 1

2021-03-23

Symptoms: Headaches and general fatigue.

Release 7 — day 21, dose 2

2021-04-21

Symptoms: Stomach upset, lethargy, and trouble sleeping.

Release 8 — day 28, dose 2

2021-04-27

Symptoms: Substantial itching and hives at night- even after taking an antihistamine.

Release 8 — day 35, dose 2

2021-05-04

Symptoms: Sleep disruptions, congestion

Release 9 — 6 months, dose 2

2021-09-28

Symptoms: Booster in shoulder joint rather than muscle caused it to lock up a bit.

Release 10 — 3 months, dose 3

2021-11-21

Symptoms: Rashes.

Release 11 — day 21, dose 4

2022-05-15

Symptoms: Hives and substantial allergic reaction related to insect bites or ant stings. EpiPen and prednisone prescribed/administered.

Release 11 — day 28, dose 4

2022-05-20

Symptoms: Medication taken in response to my allergic reaction to ant sting/bites recieved Saturday, has disrupted my sleep, considerably.

Healthcare visit (other): Questions raised at previously regularly scheduled rheumatology appointment.

Release 11 — day 42, dose 4

2022-06-06

Symptoms: Continue to have periodic hives. They seem to be somewhat more frequent this year than last, though they've always occurred.

Release 12 — 3 months, dose 4

2022-07-23

Symptoms: A dermatological issue on my lip, and a short sinus infection.

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	Office visit	·	·	✓
SD	Abdominal discomfort	✓	✓	✓
SD	Arthropod bite	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypersensitivity	·	·	✓
SD	Insomnia	✓	✓	✓
SD	Lethargy	✓	✓	✓
SD	Periarthritis	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Product administered at inappropriate site	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Rash	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Sinusitis	·	·	✓
SD	Skin disorder	·	·	✓
SD	Sleep disorder	✓	✓	✓
SD	Urticaria	✓	✓	✓

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