4V7-23071-19971

3 vaccinations 15 coded responses 32 check-ins 15 free-text entries 1 call case

Sex: Female
Age at first dose: 41-45
ZIP prefix: 983 / WA
Registered: 2021-03-30

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

Timeline

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

2021-03-21
Dose 1 — Moderna
2021-03-30
Registered in v-safe
2021-03-30
Health check-in — day 7, dose 1
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work

Adult check-in
2021-04-04
Survey response — day 14, dose 1
MedDRA: Hypersensitivity, Pyrexia — Feeling: Good · Be unable to work, 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: Covid arm. Fever.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Report sent to call center — day 14, 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)
2021-04-11
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-18
Dose 2 — Moderna
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-20
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary mass — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · 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

Free text: Tennis ball size lump under arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Itching · 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
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-25
Health check-in — day 7, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-02
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-09
Survey response — day 21, dose 2
MedDRA: Unevaluable event — Feeling: Good · Be unable to do your normal daily activities

Free text: Received a tetanus shot and had a reaction

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-23
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-30
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-16
Call 1 — Left Voicemail
2021-07-18
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-17
Survey response — 6 months, dose 2
MedDRA: Cough, Fatigue, Headache — Feeling: Fair · Be unable to work or attend school

Free text: Cough, fatigue. Headaches.

MedDRA releases: 2024-11 · check-in free text available
2022-01-10
Dose 3 — Moderna
2022-01-10
Health check-in — day 0, dose 3
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-01-11
Survey response — days 1–6 daily, dose 3
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Free text: Swollen lymph node in left arm pit area. Extremely painful

MedDRA releases: 2024-11 · check-in free text available
2022-01-12
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2022-01-13
Survey response — days 1–6 daily, dose 3
MedDRA: Cough — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school

Free text: Cough

MedDRA releases: 2024-11 · check-in free text available
2022-01-14
Survey response — days 1–6 daily, dose 3
MedDRA: Cough, Lymphadenopathy, Nasal congestion — Feeling: Poor · Site: Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Hard coughs, swollen lymph node under left arm, nasal congestion

MedDRA releases: 2024-11 · check-in free text available
2022-01-15
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy, Paranasal sinus discomfort, Respiratory tract congestion, SARS-CoV-2 test positive — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Positive covid test 01-14-22; congestion; cough; swollen lymph node under arm; sinus pressure

MedDRA releases: 2024-11 · check-in free text available
2022-01-16
Survey response — days 1–6 daily, dose 3
MedDRA: Cough, Respiratory tract congestion — Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Cough, congestion

MedDRA releases: 2024-11 · check-in free text available
2022-01-17
Survey response — day 7, dose 3
MedDRA: COVID-19 — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Covid positive 1-15-22

MedDRA releases: 2024-11 · check-in free text available
2022-01-25
Survey response — day 14, dose 3
MedDRA: Ageusia, Chest discomfort, Dyspnoea, Respiratory tract congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Heaviness in chest, harder to take deep breaths. Loss of taste. Congestion.

MedDRA releases: 2024-11 · check-in free text available
2022-01-31
Survey response — day 21, dose 3
MedDRA: Chest discomfort, Cough — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Deep cough, heaviness in chest

MedDRA releases: 2024-11 · check-in free text available
2022-02-07
Survey response — day 28, dose 3
MedDRA: Chest discomfort, Cough, Fatigue, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activities

Free text: Extreme Fatigue. Congestion and heaviness in chest. Cough.

MedDRA releases: 2024-11 · check-in free text available
2022-02-14
Survey response — day 35, dose 3
MedDRA: Ageusia, Anosmia, Cough, Headache, Respiratory tract congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Over 1 month of coughs and congestion. Taste and smell come and go. Headaches.

MedDRA releases: 2024-11 · check-in free text available
2022-02-21
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-04-11
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-07-11
Survey response — 6 months, dose 3
MedDRA: Chest discomfort, Dyspnoea, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue. Tightness in chest. Winded easily.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-21	Moderna
2	2021-04-18	Moderna
3	2022-01-10	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 6 — day 14, dose 1

2021-04-04

Symptoms: Covid arm. Fever.

Release 7 — days 1–6 daily, dose 2

2021-04-20

Systemic reaction (other): Tennis ball size lump under arm

Release 8 — day 21, dose 2

2021-05-09

Symptoms: Received a tetanus shot and had a reaction

Release 10 — 6 months, dose 2

2021-10-17

Symptoms: Cough, fatigue. Headaches.

Release 10 — days 1–6 daily, dose 3

2022-01-11

Systemic reaction (other): Swollen lymph node in left arm pit area. Extremely painful

2022-01-13

Systemic reaction (other): Cough

2022-01-14

Systemic reaction (other): Hard coughs, swollen lymph node under left arm, nasal congestion

2022-01-15

Systemic reaction (other): Positive covid test 01-14-22; congestion; cough; swollen lymph node under arm; sinus pressure

2022-01-16

Systemic reaction (other): Cough, congestion

Release 10 — day 7, dose 3

2022-01-17

Systemic reaction (other): Covid positive 1-15-22

Release 11 — day 14, dose 3

2022-01-25

Symptoms: Heaviness in chest, harder to take deep breaths. Loss of taste. Congestion.

Release 11 — day 21, dose 3

2022-01-31

Symptoms: Deep cough, heaviness in chest

Release 11 — day 28, dose 3

2022-02-07

Symptoms: Extreme Fatigue. Congestion and heaviness in chest. Cough.

Release 11 — day 35, dose 3

2022-02-14

Symptoms: Over 1 month of coughs and congestion. Taste and smell come and go. Headaches.

Release 12 — 6 months, dose 3

2022-07-11

Symptoms: Fatigue. Tightness in chest. Winded easily.

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	Ageusia	·	·	✓
SD	Anosmia	·	·	✓
SD	Chest discomfort	·	·	✓
SD	Cough	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Hypersensitivity	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Unevaluable event	✓	✓	✓
SRO	Axillary mass	✓	✓	✓
SRO	Cough	·	·	✓
SRO	COVID-19	·	·	✓
SRO	Lymph node pain	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Nasal congestion	·	·	✓
SRO	Paranasal sinus discomfort	·	·	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	SARS-CoV-2 test positive	·	·	✓

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