4PW-26878-51134

2 vaccinations 8 coded responses 25 check-ins 8 free-text entries 0 call cases

Sex: —
Age at first dose: 61-65
ZIP prefix: 834 / ID
Registered: 2021-01-18

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

2021-01-18
Registered in v-safe
2021-01-18
Dose 1 — Moderna
2021-01-18
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Rash, not including the immediate area around the injection site

Adult check-in
2021-01-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-25
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-08
Survey response — day 21, dose 1
MedDRA: Dizziness, Nausea — Feeling: Good

Free text: Very mild sense of dizzyness and just a hint of nausea for a couple of hours this morning.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-18
Dose 2 — Moderna
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Headache, Abdominal pain

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Nausea

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache

Adult check-in
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Fair · Site: Redness, Swelling · Nausea

Free text: Fuzzy thinking

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good · Site: Redness, Swelling, Itching · Headache, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Headache, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site

Adult check-in
2021-03-04
Survey response — day 14, dose 2
MedDRA: Asthenia, Rash — Feeling: Good

Free text: Worsening rash not on the injection site, and lack of energy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — day 21, dose 2
MedDRA: Confusional state, Fatigue, Rash — Feeling: Fair

Free text: More tiredness, mental confusion, rash.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — day 28, dose 2
MedDRA: Nausea, Vertigo — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: Vertigo that lasted 3 days. Nausea the first day

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-01
Survey response — day 42, dose 2
MedDRA: Depression, Fatigue — Feeling: Good · Be unable to do your normal daily activities

Free text: Extra tiredness and depression. But I dont know if its COVID related.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-19
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-18
Survey response — 12 months, dose 2
MedDRA: Exposure to SARS-CoV-2, Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Good

Free text: Cold-like symptoms for a few days in January. My husband tested positive for Covid with the rapid test. I tested negative.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-18	Moderna
2	2021-02-18	Moderna

Free text

Release 3 — day 21, dose 1

2021-02-08

Symptoms: Very mild sense of dizzyness and just a hint of nausea for a couple of hours this morning.

Release 4 — days 1–6 daily, dose 2

2021-02-23

Systemic reaction (other): Fuzzy thinking

2021-02-24

Systemic reaction (other): Sore throat

Release 5 — day 14, dose 2

2021-03-04

Symptoms: Worsening rash not on the injection site, and lack of energy.

Release 5 — day 21, dose 2

2021-03-11

Symptoms: More tiredness, mental confusion, rash.

Release 5 — day 28, dose 2

2021-03-18

Symptoms: Vertigo that lasted 3 days. Nausea the first day

Release 6 — day 42, dose 2

2021-04-01

Symptoms: Extra tiredness and depression. But I dont know if its COVID related.

Release 11 — 12 months, dose 2

2022-02-18

Symptoms: Cold-like symptoms for a few days in January. My husband tested positive for Covid with the rapid test. I tested negative.

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	Asthenia	✓	✓	✓
SD	Confusional state	✓	✓	✓
SD	Depression	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Nausea	✓	✓	✓
SD	Rash	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Vertigo	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓

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