4DA-31647-08868

4 vaccinations 16 coded responses 36 check-ins 16 free-text entries 3 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 906 / CA
Registered: 2021-05-13

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-05-13
Registered in v-safe
2021-05-13
Dose 1 — Moderna
2021-05-13
Survey response — day 0, dose 1
MedDRA: Rash erythematous — Feeling: Fair · Site: Pain

Free text: Sunburn feelings around face

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Itchy feeling on body in addition to face. Comes and goes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Oral discomfort, Oropharyngeal pain, Upper-airway cough syndrome — Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Cough post nasal drip throat irritating burn sensation down throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus — Feeling: Good · Headache

Free text: Itchy different parts if body now and then but no rash

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-05-18
Survey response — days 1–6 daily, dose 1
MedDRA: Sinus pain — Feeling: Good

Free text: Sinus pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus, Sinus pain — Feeling: Good

Free text: Sinus pain and itchy skin

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Survey response — day 7, dose 1
MedDRA: Rash, Rash macular — Feeling: Fair

Free text: Couple red spots/wilt on face

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-06-03
Survey response — day 21, dose 1
MedDRA: Myalgia — Feeling: Fair

Free text: Muscle aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Dose 2 — Moderna
2021-06-10
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-06-11
Survey response — days 1–6 daily, dose 2
MedDRA: Flatulence — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Gassy stomach

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-12
Survey response — days 1–6 daily, dose 2
MedDRA: Contusion — Feeling: Good · Muscle or body aches

Free text: Bruise where arm was injected

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-13
Survey response — days 1–6 daily, dose 2
MedDRA: Contusion, Tenderness — Feeling: Good · Fatigue or tiredness

Free text: Arm still a little tender from bruise

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-14
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site bruising — Feeling: Good

Free text: Brise in injection spot tirned yellow in color

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Nausea

Adult check-in
2021-06-16
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site bruising — Feeling: Good

Free text: Bruise at site better

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-17
Health check-in — day 7, dose 2
Feeling: Good · Nausea

Adult check-in
2021-06-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-07-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-07-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-07-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-07-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-09-09
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-12-10
Dose 3 — Moderna
2022-06-13
Dose 4 — Moderna
2022-06-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-06-15
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-06-16
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-06-17
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-06-18
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Muscle or body aches

Adult check-in
2022-06-20
Health check-in — day 7, dose 4
Feeling: Good · Muscle or body aches

Adult check-in
2022-06-27
Survey response — day 14, dose 4
MedDRA: COVID-19 — Feeling: Poor · Be unable to work or attend school, 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: Contracted covid

MedDRA releases: 2024-11 · check-in free text available
2022-06-27
Report sent to call center — day 14, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-06-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-07-04
Survey response — day 21, dose 4
MedDRA: Cough, Fatigue, Pyrexia, Quarantine, SARS-CoV-2 test positive, Unevaluable event — Feeling: Fair · 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: Contracted covid pcr test dated 6/25/22. Been in isolation for cough throat fever sinus fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-07-04
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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-07-05
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-07-13
Survey response — day 28, dose 4
MedDRA: COVID-19 — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: As moted before i contracted covid not related to vaccine

MedDRA releases: 2024-11 · check-in free text available
2022-07-13
Report sent to call center — day 28, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-07-14
Call 1 — Left Voicemail
2022-07-14
Call 1 — Left Voicemail
2022-07-14
Call 1 — Left Voicemail
2022-07-14
Call successful
Other
2022-07-20
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-25
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-09-12
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-13	Moderna
2	2021-06-10	Moderna
3	2021-12-10	Moderna	No
4	2022-06-13	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 8 — day 0, dose 1

2021-05-13

Systemic reaction (other): Sunburn feelings around face

Release 8 — days 1–6 daily, dose 1

2021-05-14

Systemic reaction (other): Itchy feeling on body in addition to face. Comes and goes

2021-05-15

Systemic reaction (other): Cough post nasal drip throat irritating burn sensation down throat

2021-05-16

Systemic reaction (other): Itchy different parts if body now and then but no rash

2021-05-18

Systemic reaction (other): Sinus pain

2021-05-19

Systemic reaction (other): Sinus pain and itchy skin

Release 8 — day 7, dose 1

2021-05-20

Systemic reaction (other): Couple red spots/wilt on face

Release 8 — day 21, dose 1

2021-06-03

Symptoms: Muscle aches

Release 9 — days 1–6 daily, dose 2

2021-06-11

Systemic reaction (other): Gassy stomach

2021-06-12

Systemic reaction (other): Bruise where arm was injected

2021-06-13

Systemic reaction (other): Arm still a little tender from bruise

2021-06-14

Systemic reaction (other): Brise in injection spot tirned yellow in color

2021-06-16

Systemic reaction (other): Bruise at site better

Release 12 — day 14, dose 4

2022-06-27

Symptoms: Contracted covid

Release 12 — day 21, dose 4

2022-07-04

Symptoms: Contracted covid pcr test dated 6/25/22. Been in isolation for cough throat fever sinus fatigue

Release 12 — day 28, dose 4

2022-07-13

Symptoms: As moted before i contracted covid not related to vaccine

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	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Fatigue	·	·	✓
SD	Myalgia	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Quarantine	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Unevaluable event	·	·	✓
SRO	Contusion	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Flatulence	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Oral discomfort	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash erythematous	✓	✓	✓
SRO	Rash macular	✓	✓	✓
SRO	Sinus pain	✓	✓	✓
SRO	Tenderness	✓	✓	✓
SRO	Upper-airway cough syndrome	✓	✓	✓

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