4BB-27799-86512

3 vaccinations 14 coded responses 28 check-ins 14 free-text entries 0 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 622 / IL
Registered: 2021-04-28

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

2021-04-01
Dose 1 — Moderna
2021-04-28
Registered in v-safe
2021-04-28
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-29
Dose 2 — Moderna
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · None

Adult check-in
2021-05-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache · Be unable to do your normal daily activities

Adult check-in
2021-05-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-05
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Fatigue or tiredness, Vomiting · Be unable to do your normal daily activities

Free text: Light headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Survey response — day 7, dose 2
MedDRA: Dizziness — Feeling: Poor · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Light headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — day 14, dose 2
MedDRA: Abdominal pain upper, Diarrhoea, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Diarrhea, stomach ache, headache

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

Adult check-in
2021-05-28
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-06-03
Survey response — day 35, dose 2
MedDRA: Chest discomfort, Chest pain, Diarrhoea, Headache, Vomiting — Feeling: Fair · Be unable to do your normal daily activities

Free text: Vomiting, diarrhea, headache. Sometimes I feel my chest is tight or hurting a bit. But might be allergies as well? But not like the heart.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-30
Survey response — 3 months, dose 2
MedDRA: Hypoaesthesia, Paraesthesia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Numbness and tingling in arms and legs

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-28
Dose 3 — Moderna
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-29
Survey response — 6 months, dose 2
MedDRA: Fatigue, Pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Got booster shot. So sore and tired

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-11-01
Survey response — days 1–6 daily, dose 3
MedDRA: Paraesthesia — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Tingling in hands

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Paraesthesia — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Tingling in hands

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Survey response — days 1–6 daily, dose 3
MedDRA: Hypoaesthesia, Paraesthesia — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Tingling and numbness in hands

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Health check-in — day 7, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-11
Survey response — day 14, dose 3
MedDRA: Joint swelling — Feeling: Fair

Free text: Had swollen ankles for few days

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-11-25
Survey response — day 28, dose 3
MedDRA: Nausea, Vomiting — Feeling: Fair · Be unable to do your normal daily activities

Free text: Nauseous and vomiting

MedDRA releases: 2024-11 · check-in free text available
2021-12-02
Survey response — day 35, dose 3
MedDRA: Diarrhoea, Gastrointestinal disorder, Hypoaesthesia, Paraesthesia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Diarrhea and tummy problems. Tingling/numbness in hands and sometimes feet.

MedDRA releases: 2024-11 · check-in free text available
2021-12-11
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-27
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-04-28
Survey response — 6 months, dose 3
MedDRA: Brain fog, Feeling hot, Headache, Nausea, Peripheral swelling, Rash — Feeling: Fair · Be unable to do your normal daily activities

Free text: Rash, headache, arm swollen and hot, nausea, foggy thi king

MedDRA releases: 2024-11 · check-in free text available
2022-10-30
Survey response — 12 months, dose 3
MedDRA: Fatigue, Gastrointestinal disorder, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue, digestive issues, and organ issues

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-01	Moderna
2	2021-04-29	Moderna
3	2021-10-28	Moderna	No

Free text

Release 8 — days 1–6 daily, dose 2

2021-05-05

Systemic reaction (other): Light headed

Release 8 — day 7, dose 2

2021-05-06

Systemic reaction (other): Light headed

Release 8 — day 14, dose 2

2021-05-14

Symptoms: Diarrhea, stomach ache, headache

Release 8 — day 35, dose 2

2021-06-03

Symptoms: Vomiting, diarrhea, headache. Sometimes I feel my chest is tight or hurting a bit. But might be allergies as well? But not like the heart.

Release 9 — 3 months, dose 2

2021-07-30

Symptoms: Numbness and tingling in arms and legs

Release 10 — 6 months, dose 2

2021-10-29

Symptoms: Got booster shot. So sore and tired

Release 10 — days 1–6 daily, dose 3

2021-11-01

Systemic reaction (other): Tingling in hands

2021-11-02

Systemic reaction (other): Tingling in hands

2021-11-03

Systemic reaction (other): Tingling and numbness in hands

Release 10 — day 14, dose 3

2021-11-11

Symptoms: Had swollen ankles for few days

Release 10 — day 28, dose 3

2021-11-25

Symptoms: Nauseous and vomiting

Release 10 — day 35, dose 3

2021-12-02

Symptoms: Diarrhea and tummy problems. Tingling/numbness in hands and sometimes feet.

Release 11 — 6 months, dose 3

2022-04-28

Symptoms: Rash, headache, arm swollen and hot, nausea, foggy thi king

Release 12 — 12 months, dose 3

2022-10-30

Symptoms: Fatigue, digestive issues, and organ issues

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 pain upper	✓	✓	✓
SD	Brain fog	·	·	✓
SD	Chest discomfort	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Feeling hot	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Headache	✓	✓	✓
SD	Hypoaesthesia	✓	·	✓
SD	Joint swelling	·	·	✓
SD	Nausea	·	·	✓
SD	Pain	·	·	✓
SD	Paraesthesia	✓	·	✓
SD	Peripheral swelling	·	·	✓
SD	Rash	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Vomiting	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Hypoaesthesia	·	·	✓
SRO	Paraesthesia	·	·	✓

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