46Z-22255-70027

3 vaccinations 10 coded responses 34 check-ins 10 free-text entries 0 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 077 / NJ
Registered: 2021-04-20

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

2021-04-20
Registered in v-safe
2021-04-20
Dose 1 — Moderna
2021-04-20
Survey response — day 0, dose 1
MedDRA: Disturbance in attention, Dizziness, Feeling abnormal, Immediate post-injection reaction, Pain in extremity — Feeling: Good · Site: Pain, Swelling · Headache

Free text: Arm pain after 10 min after receiving vaccine. Also, I experienced dizziness that subsided after drinking 3 glasses of water. For the rest of the day, I felt like I had high dopamine levels and trouble to focus.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Good · Site: Pain · Headache

Free text: Dizziness upon waking up in the morning.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-04-26
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Yesterday, I had fatigue too. I forgot to check in.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-05-06
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-18
Dose 2 — Moderna
2021-05-18
Survey response — day 0, dose 2
MedDRA: Dizziness, Immediate post-injection reaction — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizzy 10min after vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-05-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-27
Survey response — day 7, dose 2
MedDRA: Heavy menstrual bleeding, Unevaluable event, Vaccine positive rechallenge — Feeling: Good

Free text: Menstruated longer then usual. The same happened after first vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-08
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-22
Survey response — day 35, dose 2
MedDRA: Heavy menstrual bleeding, Menstrual clots — Feeling: Good

Free text: I had very heavy menstruation with blood cloths about 2inch in diameter.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-01
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-18
Survey response — 3 months, dose 2
MedDRA: Heavy menstrual bleeding, SARS-CoV-2 antibody test — Feeling: Good

Free text: Menstruation feels heavier. I checked Covid antibodies. They are at level 930

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-16
Survey response — 6 months, dose 2
MedDRA: Heavy menstrual bleeding — Feeling: Fair

Free text: Menstruation is still heavier then before vaccine.

MedDRA releases: 2024-11 · check-in free text available
2022-01-04
Dose 3 — Pfizer-BioNTech
2022-01-05
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-01-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2022-01-07
Survey response — days 1–6 daily, dose 3
MedDRA: Headache — Feeling: Good · Site: Pain

Free text: Headache

MedDRA releases: 2024-11 · check-in free text available
2022-01-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2022-01-11
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-01-18
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2022-01-25
Survey response — day 21, dose 3
MedDRA: Fatigue, Headache, Nausea, Sneezing — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Covid symptoms- extreme fatigue, headache, nausea, sneezing for 4 days. Pcr test on day 2 of symptoms was negative. Subsequent rapid tests were negative too. Vaccinated 8 year old son tested positive on Jan 20th having symptoms since Jan 17

MedDRA releases: 2024-11 · check-in free text available
2022-02-01
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-02-08
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-04-07
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-07-06
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2023-01-04
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-20	Moderna
2	2021-05-18	Moderna
3	2022-01-04	Pfizer-BioNTech	No

Free text

Release 7 — day 0, dose 1

2021-04-20

Systemic reaction (other): Arm pain after 10 min after receiving vaccine. Also, I experienced dizziness that subsided after drinking 3 glasses of water. For the rest of the day, I felt like I had high dopamine levels and trouble to focus.

Release 7 — days 1–6 daily, dose 1

2021-04-21

Systemic reaction (other): Dizziness upon waking up in the morning.

Release 8 — days 1–6 daily, dose 1

2021-04-26

Systemic reaction (other): Yesterday, I had fatigue too. I forgot to check in.

Release 8 — day 0, dose 2

2021-05-18

Systemic reaction (other): Dizzy 10min after vaccination.

Release 8 — day 7, dose 2

2021-05-27

Systemic reaction (other): Menstruated longer then usual. The same happened after first vaccination.

Release 9 — day 35, dose 2

2021-06-22

Symptoms: I had very heavy menstruation with blood cloths about 2inch in diameter.

Release 9 — 3 months, dose 2

2021-08-18

Symptoms: Menstruation feels heavier. I checked Covid antibodies. They are at level 930

Release 10 — 6 months, dose 2

2021-11-16

Symptoms: Menstruation is still heavier then before vaccine.

Release 10 — days 1–6 daily, dose 3

2022-01-07

Systemic reaction (other): Headache

Release 11 — day 21, dose 3

2022-01-25

Symptoms: Covid symptoms- extreme fatigue, headache, nausea, sneezing for 4 days. Pcr test on day 2 of symptoms was negative. Subsequent rapid tests were negative too. Vaccinated 8 year old son tested positive on Jan 20th having symptoms since Jan 17

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	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Heavy menstrual bleeding	✓	✓	✓
SD	Menstrual clots	✓	✓	✓
SD	Nausea	·	·	✓
SD	SARS-CoV-2 antibody test	✓	·	✓
SD	Sneezing	·	·	✓
SRO	Disturbance in attention	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Headache	·	·	✓
SRO	Heavy menstrual bleeding	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Unevaluable event	○	✓	○
SRO	Vaccine positive rechallenge	✓	·	✓

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