4TW-29991-85446

3 vaccinations 12 coded responses 38 check-ins 11 free-text entries 0 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 928 / CA
Registered: 2021-01-13

Relationship: Self
Race: Multiracial
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

2021-01-12
Dose 1 — Moderna
2021-01-13
Registered in v-safe
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Gastrooesophageal reflux disease — Feeling: Good · Site: Pain

Free text: Forgot to mention that about 3-4 hours after receiving dose I had acid reflux for a few hours

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Survey response — day 7, dose 1
MedDRA: Discomfort — Feeling: Good

Free text: Discomfort in my armpit on the arm that got vaccine, feels like lymph node

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Survey response — day 14, dose 1
MedDRA: Dyspnoea, Pruritus — Feeling: Good

Free text: Itching of arm, shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-09
Dose 2 — Moderna
2021-02-09
Survey response — day 0, dose 2
MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness, Nausea

Free text: Foggy brain

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: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Dehydration, Polyuria — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Fatigue or tiredness, Nausea

Free text: Forgot to mention on day 1 I was dehydrated & had polyuria

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Itching · Fatigue or tiredness, Nausea

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-02-16
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-23
Survey response — day 14, dose 2
MedDRA: Headache, Pain — Feeling: Good · Be unable to do your normal daily activities

Free text: Have had several headaches with 7-8/10 pain Happened about 3 times in a week

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-10
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-05
Dose 3 — Moderna
2022-01-06
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to work or attend school

Adult check-in
2022-01-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Fever · Fatigue or tiredness, Nausea

Adult check-in
2022-01-08
Survey response — days 1–6 daily, dose 3
MedDRA: Chest discomfort, Cough — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness

Free text: Coughing & heavy chest feeling

MedDRA releases: 2024-11 · check-in free text available
2022-01-09
Survey response — days 1–6 daily, dose 3
MedDRA: Chest discomfort, Cough — Feeling: Good · Site: Pain, Swelling, Itching · Fatigue or tiredness, Diarrhea

Free text: Cough, heavy chest

MedDRA releases: 2024-11 · check-in free text available
2022-01-10
Survey response — days 1–6 daily, dose 3
MedDRA: Chest discomfort, Cough, Ear discomfort — Feeling: Good · Site: Pain, Itching · Fatigue or tiredness, Nausea

Free text: Full/clogged ear, heavy chest, coughing

MedDRA releases: 2024-11 · check-in free text available
2022-01-11
Survey response — days 1–6 daily, dose 3
MedDRA: Cough, Ear discomfort — Feeling: Good · Fatigue or tiredness

Free text: Coughing, plugged ear

MedDRA releases: 2024-11 · check-in free text available
2022-01-12
Survey response — day 7, dose 3
MedDRA: Cough — Feeling: Good · Muscle or body aches, Fatigue or tiredness, Diarrhea

Free text: Cough

MedDRA releases: 2024-11 · check-in free text available
2022-01-19
Health check-in — day 14, dose 3
Feeling: Poor

Adult check-in
2022-01-26
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-02-03
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-02-09
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-16
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-04-06
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-07-06
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2023-01-06
Survey response — 12 months, dose 3
MedDRA: Delivery, Perinatal depression, Postpartum anxiety, Pre-existing disease — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-12	Moderna
2	2021-02-09	Moderna
3	2022-01-05	Moderna	No

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): Forgot to mention that about 3-4 hours after receiving dose I had acid reflux for a few hours

Release 2 — day 7, dose 1

2021-01-19

Systemic reaction (other): Discomfort in my armpit on the arm that got vaccine, feels like lymph node

Release 2 — day 14, dose 1

2021-01-27

Symptoms: Itching of arm, shortness of breath

Release 3 — day 0, dose 2

2021-02-09

Systemic reaction (other): Foggy brain

Release 4 — days 1–6 daily, dose 2

2021-02-11

Systemic reaction (other): Forgot to mention on day 1 I was dehydrated & had polyuria

Release 4 — day 14, dose 2

2021-02-23

Symptoms: Have had several headaches with 7-8/10 pain Happened about 3 times in a week

Release 10 — days 1–6 daily, dose 3

2022-01-08

Systemic reaction (other): Coughing & heavy chest feeling

2022-01-09

Systemic reaction (other): Cough, heavy chest

2022-01-10

Systemic reaction (other): Full/clogged ear, heavy chest, coughing

2022-01-11

Systemic reaction (other): Coughing, plugged ear

Release 10 — day 7, dose 3

2022-01-12

Systemic reaction (other): Cough

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	Delivery	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Perinatal depression	·	·	✓
SD	Postpartum anxiety	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pruritus	✓	✓	✓
SRO	Chest discomfort	·	·	✓
SRO	Cough	·	·	✓
SRO	Dehydration	✓	✓	✓
SRO	Discomfort	✓	✓	✓
SRO	Ear discomfort	·	·	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Gastrooesophageal reflux disease	✓	✓	✓
SRO	Polyuria	✓	✓	✓

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