4GW-27718-63578

3 vaccinations 12 coded responses 36 check-ins 11 free-text entries 0 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 917 / CA
Registered: 2021-06-30

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

2021-06-27
Dose 1 — Moderna
2021-06-30
Registered in v-safe
2021-06-30
Survey response — days 1–6 daily, dose 1
MedDRA: Brain fog — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-07-03
Survey response — days 1–6 daily, dose 1
MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Raised patches on outer upper thigh on left side opposite of injection side

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-04
Health check-in — day 7, dose 1
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-07-11
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-07-18
Survey response — day 21, dose 1
MedDRA: Injection site erythema, Injection site pruritus — Feeling: Fair

Free text: Itchy and redness at site/side of vaccine...very irrating and heat seems to make worse

MedDRA releases: 2024-11 · check-in free text available
2021-07-25
Dose 2 — Moderna
2021-07-25
Health check-in — day 0, dose 2
Feeling: Fair · Site: Swelling · Fatigue or tiredness, Nausea

Adult check-in
2021-07-26
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia — Feeling: Poor · Site: Pain, Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: feel very week

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains

Adult check-in
2021-07-28
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema, Injection site warmth — Feeling: Poor · Site: Pain, Redness, Swelling, Itching

Free text: an inch below the injection site red warm today(hot last night) 6"Ã— 6" in size

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-29
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema, Injection site warmth — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Fatigue or tiredness

Free text: large red patch near injection site is much less warm than yesterday

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Joint pains

Adult check-in
2021-07-31
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Somnolence — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Free text: Very tired hard to wake up after resting

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-01
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain, Redness · Joint pains

Adult check-in
2021-08-08
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-08-15
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-08-22
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-08-29
Survey response — day 35, dose 2
MedDRA: Hypoaesthesia, Peripheral swelling — Feeling: Fair · Be unable to do your normal daily activities

Free text: Leg & Feet numbness and swelling

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

Adult check-in
2021-10-24
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-01-23
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-12
Dose 3 — Moderna
2022-02-12
Health check-in — day 0, dose 3
Feeling: Good · Site: Swelling · Joint pains, Nausea

Adult check-in
2022-02-13
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-02-14
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-02-15
Survey response — days 1–6 daily, dose 3
MedDRA: Hypogeusia, Hyposmia — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: my sense of taste and smell is very low

MedDRA releases: 2024-11 · check-in free text available
2022-02-17
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2022-02-18
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-02-19
Health check-in — day 7, dose 3
Feeling: Good · Site: Swelling, Itching · Joint pains, Fatigue or tiredness

Adult check-in
2022-02-26
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-03-05
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-03-12
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-03-19
Survey response — day 35, dose 3
MedDRA: Fatigue, Poor quality sleep — Feeling: Fair

Free text: Fatigue not sleeping well

MedDRA releases: 2024-11 · check-in free text available
2022-03-26
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-05-14
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-08-15
Survey response — 6 months, dose 3
MedDRA: Paraesthesia — Feeling: Fair

Free text: Tingly feet and toes

MedDRA releases: 2024-11 · check-in free text available
2023-02-12
Survey response — 12 months, dose 3
MedDRA: Fatigue, Rhinalgia, Sneezing — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-06-27	Moderna	No
2	2021-07-25	Moderna	No
3	2022-02-12	Moderna	No

Free text

Release 9 — days 1–6 daily, dose 1

2021-06-30

Systemic reaction (other): brain fog

2021-07-03

Systemic reaction (other): Raised patches on outer upper thigh on left side opposite of injection side

Release 9 — day 21, dose 1

2021-07-18

Symptoms: Itchy and redness at site/side of vaccine...very irrating and heat seems to make worse

Release 9 — days 1–6 daily, dose 2

2021-07-26

Systemic reaction (other): feel very week

2021-07-28

Systemic reaction (other): an inch below the injection site red warm today(hot last night) 6"Ã— 6" in size

2021-07-29

Systemic reaction (other): large red patch near injection site is much less warm than yesterday

2021-07-31

Systemic reaction (other): Very tired hard to wake up after resting

Release 9 — day 35, dose 2

2021-08-29

Symptoms: Leg & Feet numbness and swelling

Release 11 — days 1–6 daily, dose 3

2022-02-15

Systemic reaction (other): my sense of taste and smell is very low

Release 11 — day 35, dose 3

2022-03-19

Symptoms: Fatigue not sleeping well

Release 12 — 6 months, dose 3

2022-08-15

Symptoms: Tingly feet and toes

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	Hypoaesthesia	✓	·	✓
SD	Injection site erythema	·	·	✓
SD	Injection site pruritus	·	·	✓
SD	Paraesthesia	·	·	✓
SD	Peripheral swelling	✓	·	✓
SD	Poor quality sleep	·	·	✓
SD	Rhinalgia	·	·	✓
SD	Sneezing	·	·	✓
SRO	Asthenia	✓	·	✓
SRO	Brain fog	✓	✓	✓
SRO	Fatigue	✓	·	✓
SRO	Hypogeusia	·	·	✓
SRO	Hyposmia	·	·	✓
SRO	Injection site erythema	✓	·	✓
SRO	Injection site warmth	✓	·	✓
SRO	Rash	✓	✓	✓
SRO	Somnolence	✓	·	✓

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