4C3-19208-88791

3 vaccinations 6 coded responses 34 check-ins 6 free-text entries 0 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 052 / VT
Registered: 2021-04-22

Relationship: Self
Race: Multiracial
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

2021-04-22
Registered in v-safe
2021-04-22
Dose 1 — Moderna
2021-04-22
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-04-23
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Paraesthesia — Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work

Free text: The ache is going into my shoulder blade and skin over it feels a little tingly when touched or showered

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache

Free text: The arm is still a little sore directly around the injection site but it is substantially better.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Diarrhea

Adult check-in
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
2021-05-13
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-05-20
Dose 2 — Moderna
2021-05-20
Survey response — day 0, dose 2
MedDRA: Dizziness, Immediate post-injection reaction — Feeling: Good · Site: Pain · Headache

Free text: I got very dizy for a short time right after the shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-05-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-05-23
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lack of apptite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Headache

Adult check-in
2021-05-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-05-27
Health check-in — day 7, dose 2
Feeling: Good · Headache

Adult check-in
2021-06-03
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-17
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-06-24
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-07-01
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-08-19
Survey response — 3 months, dose 2
MedDRA: Aphthous ulcer — Feeling: Fair

Free text: I have had continuing out breaks of canker sores in my mouth for 3 weeks in a row. Don't know if it has anything to do with the vaccine or not, but though I would tell you. I started preventative medication for it.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-19
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-24
Dose 3 — Moderna
2021-11-26
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-27
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site induration, Injection site mass, Injection site warmth — Feeling: Poor · Site: Pain, Redness, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: The injection site is extremely hot and hard, like an lump

MedDRA releases: 2024-11 · check-in free text available
2021-11-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school

Adult check-in
2021-12-03
Health check-in — day 7, dose 3
Feeling: Fair · Site: Redness, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-12-08
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-12-15
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-12-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-29
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-05
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-23
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-25
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-11-24
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-22	Moderna
2	2021-05-20	Moderna
3	2021-11-24	Moderna	No

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-23

Systemic reaction (other): The ache is going into my shoulder blade and skin over it feels a little tingly when touched or showered

2021-04-25

Systemic reaction (other): The arm is still a little sore directly around the injection site but it is substantially better.

Release 8 — day 0, dose 2

2021-05-20

Systemic reaction (other): I got very dizy for a short time right after the shot.

Release 8 — days 1–6 daily, dose 2

2021-05-23

Systemic reaction (other): Lack of apptite

Release 9 — 3 months, dose 2

2021-08-19

Symptoms: I have had continuing out breaks of canker sores in my mouth for 3 weeks in a row. Don't know if it has anything to do with the vaccine or not, but though I would tell you. I started preventative medication for it.

Release 10 — days 1–6 daily, dose 3

2021-11-27

Systemic reaction (other): The injection site is extremely hot and hard, like an lump

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	Aphthous ulcer	✓	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Injection site induration	·	·	✓
SRO	Injection site mass	·	·	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site warmth	·	·	✓
SRO	Paraesthesia	✓	✓	✓

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