4QB-21544-43579

2 vaccinations 10 coded responses 20 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 812 / CO
Registered: 2021-01-06

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

2021-01-05
Dose 1 — Moderna
2021-01-06
Registered in v-safe
2021-01-07
Survey response — days 1–6 daily, dose 1
MedDRA: Eye pruritus, Rhinorrhoea — Feeling: Fair · Site: Pain

Free text: Nose a little runny and eyes feel itchy. Probably environmental allergies.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Survey response — days 1–6 daily, dose 1
MedDRA: Hypersensitivity, Lacrimation increased, Rhinorrhoea — Feeling: Good · Site: Pain

Free text: I think the allergy symptoms I had yesterday was due to a face cream. I washed it off my face and my symptoms, runny nose and teary eyes, went away.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-09
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Pre-existing disease, Rotator cuff syndrome — Feeling: Good · Joint pains

Free text: Joint pains due to arthritis and a partial tear in my rotator cuff.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-11
Survey response — days 1–6 daily, dose 1
MedDRA: Insomnia — Feeling: Good · Fatigue or tiredness

Free text: I didn't get a lot of sleep last night.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Survey response — day 7, dose 1
MedDRA: Back pain — Feeling: Good · Muscle or body aches

Free text: Backache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Survey response — day 14, dose 1
MedDRA: Injection site erythema — Feeling: Good

Free text: The site where I got the vaccination was reddened 10 days after the vaccine. It is still pink.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-02
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-04
Dose 2 — Moderna
2021-02-09
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal discomfort, Decreased appetite, Fatigue, Pain — Feeling: Good · Site: Pain, Itching · Be unable to do your normal daily activities

Free text: My stomach has felt irritated. The day after the Moderna vaccine I was feeling achy, tired, and lost my appetite. I feel better now except for my stomach feeling irritated.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-02-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-18
Survey response — day 42, dose 2
MedDRA: Insomnia — Feeling: Good · Be unable to do your normal daily activities

Free text: Sleeplessness. I would guess unrelated to the vaccine but I am not sure why it is getting worse.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Survey response — 3 months, dose 2
MedDRA: Office visit, Rash pruritic — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: I had a very itchy rash that I went to the doctor for. Probably not a reaction to the vaccine but to a medication. · Healthcare visit (other): Doctors office.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-07
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-05
Survey response — 12 months, dose 2
MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities

Free text: I had cold symptoms but tested negative for Covid.

MedDRA releases: 2024-11 · check-in free text available
2022-05-05
Call successful
Not applicable - Accidental Reporting

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-05	Moderna
2	2021-02-04	Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-07

Systemic reaction (other): Nose a little runny and eyes feel itchy. Probably environmental allergies.

2021-01-08

Systemic reaction (other): I think the allergy symptoms I had yesterday was due to a face cream. I washed it off my face and my symptoms, runny nose and teary eyes, went away.

2021-01-09

Systemic reaction (other): Joint pains due to arthritis and a partial tear in my rotator cuff.

2021-01-11

Systemic reaction (other): I didn't get a lot of sleep last night.

Release 1 — day 7, dose 1

2021-01-12

Systemic reaction (other): Backache

Release 2 — day 14, dose 1

2021-01-19

Symptoms: The site where I got the vaccination was reddened 10 days after the vaccine. It is still pink.

Release 3 — days 1–6 daily, dose 2

2021-02-09

Systemic reaction (other): My stomach has felt irritated. The day after the Moderna vaccine I was feeling achy, tired, and lost my appetite. I feel better now except for my stomach feeling irritated.

Release 5 — day 42, dose 2

2021-03-18

Symptoms: Sleeplessness. I would guess unrelated to the vaccine but I am not sure why it is getting worse.

Release 8 — 3 months, dose 2

2021-05-06

Symptoms: I had a very itchy rash that I went to the doctor for. Probably not a reaction to the vaccine but to a medication.

Healthcare visit (other): Doctors office.

Release 11 — 12 months, dose 2

2022-02-05

Symptoms: I had cold symptoms but tested negative for Covid.

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	Office visit	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Rash pruritic	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Abdominal discomfort	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Arthritis	○	○	○
SRO	Back pain	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Eye pruritus	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Lacrimation increased	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Rotator cuff syndrome	✓	✓	✓

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