4ME-14434-40518

4 vaccinations 19 coded responses 49 check-ins 19 free-text entries 4 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 038 / NH
Registered: 2020-12-30

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2020-12-30
Registered in v-safe
2020-12-30
Dose 1 — Moderna
2020-12-30
Health check-in — day 0, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2020-12-31
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site induration, Injection site swelling, Injection site warmth — Feeling: Good · Site: Pain, Redness, Swelling, Itching

Free text: Injection site is hot, hard, and swollen.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-01
Survey response — days 1–6 daily, dose 1
MedDRA: Tinnitus — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness

Free text: Ears ringing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-02
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site bruising — Feeling: Good · Site: Pain, Swelling · Headache

Free text: Bruising at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache

Adult check-in
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · None

Adult check-in
2021-01-06
Survey response — day 7, dose 1
MedDRA: Dizziness — Feeling: Poor · Site: Redness, Swelling, Itching · Fever · Chills, Headache, Nausea, Vomiting, Abdominal pain · Be unable to work, 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: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-06
Report sent to call center — day 7, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-13
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-20
Survey response — day 21, dose 1
MedDRA: Adverse reaction, Blood urine present — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Blood in urine x 2 days · Healthcare visit (other): Symptoms improved so delayed appointment.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-20
Report sent to call center — day 21, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-27
Dose 2 — Moderna
2021-01-27
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-01-28
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-01-30
Survey response — days 1–6 daily, dose 2
MedDRA: Blood urine present — Feeling: Fair

Free text: Blood in urine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-02-04
Health check-in — day 7, dose 2
Feeling: Fair · Headache

Adult check-in
2021-02-08
Call 1 — Left Voicemail
2021-02-11
Survey response — day 14, dose 2
MedDRA: Nausea — Feeling: Fair

Free text: Nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-02-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-03
Survey response — day 35, dose 2
MedDRA: Sciatica — Feeling: Poor · Be unable to do your normal daily activities

Free text: Severe sciatic pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — day 42, dose 2
MedDRA: Sciatica — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sciatic pain daily

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-28
Survey response — 6 months, dose 2
MedDRA: Paraesthesia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Tingling in hands and left foot

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-07
Dose 3 — Pfizer-BioNTech
2021-11-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-11-09
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Free text: Swollen lymph notes

MedDRA releases: 2024-11 · check-in free text available
2021-11-10
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Oedema — Feeling: Fair · Headache

Free text: Armpit pain and edema

MedDRA releases: 2024-11 · check-in free text available
2021-11-11
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Headache · Be unable to work or attend school

Adult check-in
2021-11-12
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Nausea

Adult check-in
2021-11-13
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-14
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-23
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-28
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-05
Survey response — day 28, dose 3
MedDRA: Migraine — Feeling: Good · Be unable to do your normal daily activities

Free text: Migraine

MedDRA releases: 2024-11 · check-in free text available
2021-12-14
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-06
Survey response — 3 months, dose 3
MedDRA: Balance disorder, Chest pain, Memory impairment, Urticaria — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Hives, chest pain, memory issues, loss of balance

MedDRA releases: 2024-11 · check-in free text available
2022-02-06
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-07
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-05-12
Survey response — 6 months, dose 3
MedDRA: Cyst, Cyst removal — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Rapidly growing cyst that required removal

MedDRA releases: 2024-11 · check-in free text available
2022-05-12
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-13
Call 1 — Left Voicemail
2022-10-17
Dose 4 — Moderna
Co-administered: Flu
2022-10-17
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-10-18
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Headache, Nausea

Adult check-in
2022-10-19
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Fever · Muscle or body aches, Nausea · Be unable to work or attend school

Adult check-in
2022-10-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-10-26
Health check-in — day 7, dose 4
Feeling: Good · Headache

Adult check-in
2022-10-31
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-11-07
Survey response — day 21, dose 4
MedDRA: SARS-CoV-2 test positive — Feeling: Good · Be unable to work or attend school

Free text: Tested positive for COVID-19

MedDRA releases: 2024-11 · check-in free text available
2022-11-14
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-21
Survey response — day 35, dose 4
MedDRA: Cough, Oropharyngeal pain, Pain, Pyrexia — Feeling: Poor · Be unable to work or attend school

Free text: Fever, body aches, cough, sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-11-28
Survey response — day 42, dose 4
MedDRA: Cough, Fatigue, Oropharyngeal pain — Feeling: Fair · Be unable to work or attend school

Free text: Sore throat, cough, fatigue

MedDRA releases: 2024-11 · check-in free text available
2023-01-19
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-30	Moderna
2	2021-01-27	Moderna
3	2021-11-07	Pfizer-BioNTech	No
4	2022-10-17	Moderna	Flu

Call center

4 call center cases

3 successful · 1 unsuccessful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-31

Systemic reaction (other): Injection site is hot, hard, and swollen.

2021-01-01

Systemic reaction (other): Ears ringing

2021-01-02

Systemic reaction (other): Bruising at injection site

Release 1 — day 7, dose 1

2021-01-06

Systemic reaction (other): Dizziness

Release 2 — day 21, dose 1

2021-01-20

Symptoms: Blood in urine x 2 days

Healthcare visit (other): Symptoms improved so delayed appointment.

Release 2 — days 1–6 daily, dose 2

2021-01-28

Systemic reaction (other): Dizziness

Release 3 — days 1–6 daily, dose 2

2021-01-30

Systemic reaction (other): Blood in urine

Release 4 — day 14, dose 2

2021-02-11

Symptoms: Nausea

Release 4 — day 35, dose 2

2021-03-03

Symptoms: Severe sciatic pain

Release 5 — day 42, dose 2

2021-03-10

Symptoms: Sciatic pain daily

Release 9 — 6 months, dose 2

2021-07-28

Symptoms: Tingling in hands and left foot

Release 10 — days 1–6 daily, dose 3

2021-11-09

Systemic reaction (other): Swollen lymph notes

2021-11-10

Systemic reaction (other): Armpit pain and edema

Release 10 — day 28, dose 3

2021-12-05

Symptoms: Migraine

Release 11 — 3 months, dose 3

2022-02-06

Symptoms: Hives, chest pain, memory issues, loss of balance

Release 11 — 6 months, dose 3

2022-05-12

Symptoms: Rapidly growing cyst that required removal

Release 12 — day 21, dose 4

2022-11-07

Symptoms: Tested positive for COVID-19

Release 12 — day 35, dose 4

2022-11-21

Symptoms: Fever, body aches, cough, sore throat

Release 12 — day 42, dose 4

2022-11-28

Symptoms: Sore throat, cough, fatigue

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
HCVO	Adverse reaction	✓	✓	✓
SD	Balance disorder	·	·	✓
SD	Blood urine present	✓	✓	✓
SD	Chest pain	·	·	✓
SD	Cough	·	·	✓
SD	Cyst	·	·	✓
SD	Cyst removal	·	·	✓
SD	Fatigue	·	·	✓
SD	Memory impairment	·	·	✓
SD	Migraine	·	·	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Paraesthesia	✓	·	✓
SD	Pyrexia	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Sciatica	✓	✓	✓
SD	Urticaria	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Blood urine present	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Injection site induration	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Injection site warmth	✓	✓	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Oedema	·	·	✓
SRO	Tinnitus	✓	✓	✓

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