4RV-59483-19968

3 vaccinations 11 coded responses 27 check-ins 11 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 960 / CA
Registered: 2021-02-12

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline

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

2021-02-12
Registered in v-safe
2021-02-12
Dose 1 — Moderna
2021-02-12
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-14
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Good

Free text: Arm is sore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-26
Survey response — day 14, dose 1
MedDRA: Nausea, Pyrexia — Feeling: Good

Free text: Fever and nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-12
Dose 2 — Moderna
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site rash — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Rash around the injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema, Injection site pruritus, Injection site swelling — Feeling: Good · Site: Redness, Swelling, Itching

Free text: The itching and swelling and redness at the injection site is bothersome.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema, Rash — Feeling: Good · Site: Redness, Swelling, Itching

Free text: Looks like redness is clearing up at injection site but rash has spread a little

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Injection site swelling, Pruritus, Rash — Feeling: Good · Site: Redness, Itching

Free text: Swelling around injection site has gone down, redness is dissipating, rash has stopped spreading and itchiness is less

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-11
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-16
Survey response — 6 months, dose 2
MedDRA: Palpitations, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Heart palpitations and I think it is a reaction to the vaccination · Healthcare visit (other): My doctor

MedDRA releases: 2024-11 · check-in free text available
2021-09-16
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-19
Call 1 — Left Voicemail
2021-10-22
Dose 3 — Moderna
Co-administered: Flu
2021-10-25
Survey response — days 1–6 daily, dose 3
MedDRA: Palpitations — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Free text: Heart palpitations

MedDRA releases: 2024-11 · check-in free text available
2021-10-26
Survey response — days 1–6 daily, dose 3
MedDRA: Palpitations — Feeling: Good · Site: Pain, Redness, Itching

Free text: Heart palpitations

MedDRA releases: 2024-11 · check-in free text available
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Itching · Headache

Adult check-in
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Palpitations — Feeling: Good

Free text: Heart palpitations

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Survey response — day 7, dose 3
MedDRA: Palpitations — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Heart palpitations

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Report sent to call center — day 7, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-01
Call 1 — Left Voicemail
2021-11-05
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-12	Moderna
2	2021-03-12	Moderna
3	2021-10-22	Moderna	Flu

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-14

Systemic reaction (other): Arm is sore

Release 4 — day 14, dose 1

2021-02-26

Symptoms: Fever and nausea

Release 5 — days 1–6 daily, dose 2

2021-03-14

Systemic reaction (other): Rash around the injection site

2021-03-15

Systemic reaction (other): The itching and swelling and redness at the injection site is bothersome.

2021-03-16

Systemic reaction (other): Looks like redness is clearing up at injection site but rash has spread a little

2021-03-17

Systemic reaction (other): Swelling around injection site has gone down, redness is dissipating, rash has stopped spreading and itchiness is less

Release 9 — 6 months, dose 2

2021-09-16

Symptoms: Heart palpitations and I think it is a reaction to the vaccination

Healthcare visit (other): My doctor

Release 10 — days 1–6 daily, dose 3

2021-10-25

Systemic reaction (other): Heart palpitations

2021-10-26

Systemic reaction (other): Heart palpitations

2021-10-28

Systemic reaction (other): Heart palpitations

Release 10 — day 7, dose 3

2021-10-29

Systemic reaction (other): Heart palpitations

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	Unevaluable event	·	·	✓
SD	Nausea	✓	✓	✓
SD	Palpitations	·	·	✓
SD	Pyrexia	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	Injection site rash	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Palpitations	·	·	✓
SRO	Pruritus	✓	✓	✓
SRO	Rash	✓	✓	✓

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