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4WX-21655-93761

5 vaccinations 21 coded responses 44 check-ins 20 free-text entries 0 call cases
Sex
Female
Age at first dose
61-65
ZIP prefix
960 / CA
Registered
2021-02-08
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-08
    Registered in v-safe
  2. 2021-02-08
    Dose 1 — Moderna
  3. 2021-02-08
    Survey response — day 0, dose 1
    MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Fatigue or tiredness
    Free text: mildly sore throat
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-02-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain, Swelling · Fever · Joint pains, Fatigue or tiredness
    Adult check-in
  5. 2021-02-10
    Survey response — days 1–6 daily, dose 1
    MedDRA: Oropharyngeal pain — Feeling: Good · Site: Pain · Joint pains
    Free text: My sore tonsils stopped hurting last night.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-11
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · None
    Adult check-in
  7. 2021-02-12
    Survey response — days 1–6 daily, dose 1
    MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good · Joint pains
    Free text: my knees had joint pain yesterday and today, but only slightly more than usual.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-02-14
    Survey response — days 1–6 daily, dose 1
    MedDRA: Adverse reaction — Feeling: Good · Joint pains
    Free text: I feel wonderful today, excited for the second vaccination!
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-02-15
    Survey response — day 7, dose 1
    MedDRA: Hot flush, Night sweats — Feeling: Good
    Free text: Well, I don't know if associated, but I dod experience night sweats and intermittent periods almost like hot flashes, but haven't had hot flashes in a couple of years...no fever. Otherwise, I feel great!
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-02-22
    Survey response — day 14, dose 1
    MedDRA: Injection site pruritus, Injection site scab, Self-medication — Feeling: Good
    Free text: Oddly, last Saturday Feb 20, 2021, the injection site itself began itching. Until then, I had been unaware of the teeny-tiny scab. The itching subsided after administration of cortisone cream, but I found it odd so reporting.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-03-01
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-03-08
    Dose 2 — Moderna
  13. 2021-03-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  14. 2021-03-10
    Survey response — days 1–6 daily, dose 2
    MedDRA: Fatigue, Headache — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities
    Free text: Severe headache, major fatigue
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-03-11
    Survey response — days 1–6 daily, dose 2
    MedDRA: Adverse reaction — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Fatigue or tiredness · Be unable to work
    Free text: much better today wish I had read the AARP article about what you should know before your 2nd shot!
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-03-12
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site discharge, Injection site reaction, Injection site vesicles, Scratch, Self-medication — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness, Diarrhea, Abdominal pain
    Free text: The injection site has slightly bubbled, looks somewhat like a bite of a fire ant. I inadvertently scratched at it and displayed the skin, so applied neosporin (sp?) and a small bandaid...it's all good
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-03-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness, Swelling, Itching · Fatigue or tiredness, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site
    Adult check-in
  18. 2021-03-14
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness, Swelling, Itching · Headache, Fatigue or tiredness, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site
    Adult check-in
  19. 2021-03-15
    Health check-in — day 7, dose 2
    Feeling: Good · Site: Redness, Itching · Headache, Fatigue or tiredness, Diarrhea
    Adult check-in
  20. 2021-03-22
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-03-29
    Survey response — day 21, dose 2
    MedDRA: Pruritus, Skin lesion — Feeling: Good
    Free text: I've developed a small sore on the arm vaccinated...it showed up after the first vaccination, but went away. Last week, on Tues March 24th, it returned & unlike the first appearance, it is still here, itchy/won't go away. I will have dr look at it.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-04-07
    Survey response — day 28, dose 2
    MedDRA: Rash, Rash erythematous — Feeling: Good
    Free text: Persistent, light red rash on left cheek...never there before 2nd vaccination. Not bothersome...but hope it will eventually go away.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  23. 2021-04-12
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-04-19
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-06-07
    Survey response — 3 months, dose 2
    MedDRA: Body temperature increased, Erythema — Feeling: Good
    Free text: When I had temp of 104.9° 2nd night, 2nd vax my face was brilliant red, like scarlet fever red. Now when I'm warm from exertion my left upper cheek turns red, 50cent size, last occurrence yesterday. Only left cheek & never b4 happened.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  26. 2021-09-06
    Survey response — 6 months, dose 2
    MedDRA: Dry skin, Erythema, Malaise, Pyrexia — Feeling: Fair
    Free text: The skin under my eyes, upper cheekbones has changed consistency. It's now rough-feeling, and if I'm hot, turns quite red. This has happened since I had my 2nd vax of Moderna and on 2nd night was horribly ill, with a 104.9° temperature.
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  27. 2021-11-17
    Dose 3 — Moderna
  28. 2021-11-20
    Health check-in — days 1–6 daily, dose 3
    Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities
    Adult check-in
  29. 2021-11-23
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work or attend school, Be unable to do your normal daily activities
    Adult check-in
  30. 2021-11-26
    Health check-in — day 7, dose 3
    Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Fatigue or tiredness, Diarrhea
    Adult check-in
  31. 2021-12-10
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  32. 2021-12-15
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  33. 2021-12-24
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  34. 2021-12-29
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  35. 2022-02-16
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  36. 2022-05-16
    Dose 4 — Moderna
  37. 2022-05-18
    Survey response — 6 months, dose 3
    MedDRA: Headache, Injection site swelling, Pain in extremity, Peripheral swelling, Pre-existing disease, Pyrexia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Temperature of 103.5° 1st night night (5/16), 102.9° Tuesday night (5/17) and today (5/18) I'm down to 101.3°. Splitting headache, very painful and swollen arm and also swollen injection site. I have sarcoidosis and received full dose.
    MedDRA releases: 2024-11 · check-in free text available
  38. 2022-10-31
    Dose 5 — Moderna
  39. 2022-10-31
    Survey response — day 0, dose 5
    MedDRA: Tinnitus — Feeling: Good · Site: Pain, Swelling · Headache, Joint pains
    Free text: ears ringing bilateral
    MedDRA releases: 2024-11 · check-in free text available
  40. 2022-11-04
    Survey response — days 1–6 daily, dose 5
    MedDRA: Rhinorrhoea — Feeling: Fair · Site: Pain, Swelling · Fever · Joint pains, Fatigue or tiredness
    Free text: sniffles
    MedDRA releases: 2024-11 · check-in free text available
  41. 2022-11-05
    Survey response — days 1–6 daily, dose 5
    MedDRA: Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Good · Site: Pain, Swelling · Joint pains
    Free text: slight sore throat, sniffles, (negative COVID-19 test)
    MedDRA releases: 2024-11 · check-in free text available
  42. 2022-11-06
    Survey response — days 1–6 daily, dose 5
    MedDRA: Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea
    Free text: slight sire throat, sniffles - COVID-19 test neg
    MedDRA releases: 2024-11 · check-in free text available
  43. 2022-11-07
    Survey response — day 7, dose 5
    MedDRA: Acne, Rash pruritic, Rhinorrhoea — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness, Diarrhea, Rash, not including the immediate area around the injection site
    Free text: still have sniffles, rash is like a bunch of pimples that itch like mad
    MedDRA releases: 2024-11 · check-in free text available
  44. 2022-11-14
    Health check-in — day 14, dose 5
    Feeling: Good
    Adult check-in
  45. 2022-11-23
    Survey response — day 21, dose 5
    MedDRA: Rash — Feeling: Good
    Free text: I have a rash that has not gone away, and moves to different spots on my back.
    MedDRA releases: 2024-11 · check-in free text available
  46. 2022-11-28
    Health check-in — day 28, dose 5
    Feeling: Fair
    Adult check-in
  47. 2022-12-05
    Health check-in — day 35, dose 5
    Feeling: Good
    Adult check-in
  48. 2022-12-14
    Health check-in — day 42, dose 5
    Feeling: Good
    Adult check-in
  49. 2023-01-30
    Survey response — 3 months, dose 5
    MedDRA: Induration, Rash, Rash pruritic, Scab — Feeling: Fair
    MedDRA releases: 2024-11
  50. 2023-05-01
    Health check-in — 6 months, dose 5
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-08Moderna
22021-03-08Moderna
32021-11-17Moderna No
42022-05-16Moderna No
52022-10-31Moderna No

Free text

Release 3 — day 0, dose 1

2021-02-08

Systemic reaction (other): mildly sore throat

Release 4 — days 1–6 daily, dose 1

2021-02-10

Systemic reaction (other): My sore tonsils stopped hurting last night.

2021-02-12

Systemic reaction (other): my knees had joint pain yesterday and today, but only slightly more than usual.

2021-02-14

Systemic reaction (other): I feel wonderful today, excited for the second vaccination!

Release 4 — day 7, dose 1

2021-02-15

Systemic reaction (other): Well, I don't know if associated, but I dod experience night sweats and intermittent periods almost like hot flashes, but haven't had hot flashes in a couple of years...no fever. Otherwise, I feel great!

Release 4 — day 14, dose 1

2021-02-22

Symptoms: Oddly, last Saturday Feb 20, 2021, the injection site itself began itching. Until then, I had been unaware of the teeny-tiny scab. The itching subsided after administration of cortisone cream, but I found it odd so reporting.

Release 5 — days 1–6 daily, dose 2

2021-03-10

Systemic reaction (other): Severe headache, major fatigue

2021-03-11

Systemic reaction (other): much better today wish I had read the AARP article about what you should know before your 2nd shot!

2021-03-12

Systemic reaction (other): The injection site has slightly bubbled, looks somewhat like a bite of a fire ant. I inadvertently scratched at it and displayed the skin, so applied neosporin (sp?) and a small bandaid...it's all good

Release 6 — day 21, dose 2

2021-03-29

Symptoms: I've developed a small sore on the arm vaccinated...it showed up after the first vaccination, but went away. Last week, on Tues March 24th, it returned & unlike the first appearance, it is still here, itchy/won't go away. I will have dr look at it. cut off by CDC

Release 7 — day 28, dose 2

2021-04-07

Symptoms: Persistent, light red rash on left cheek...never there before 2nd vaccination. Not bothersome...but hope it will eventually go away.

Release 8 — 3 months, dose 2

2021-06-07

Symptoms: When I had temp of 104.9° 2nd night, 2nd vax my face was brilliant red, like scarlet fever red. Now when I'm warm from exertion my left upper cheek turns red, 50cent size, last occurrence yesterday. Only left cheek & never b4 happened.

Release 9 — 6 months, dose 2

2021-09-06

Symptoms: The skin under my eyes, upper cheekbones has changed consistency. It's now rough-feeling, and if I'm hot, turns quite red. This has happened since I had my 2nd vax of Moderna and on 2nd night was horribly ill, with a 104.9° temperature.

Release 11 — 6 months, dose 3

2022-05-18

Symptoms: Temperature of 103.5° 1st night night (5/16), 102.9° Tuesday night (5/17) and today (5/18) I'm down to 101.3°. Splitting headache, very painful and swollen arm and also swollen injection site. I have sarcoidosis and received full dose.

Release 12 — day 0, dose 5

2022-10-31

Systemic reaction (other): ears ringing bilateral

Release 12 — days 1–6 daily, dose 5

2022-11-04

Systemic reaction (other): sniffles

2022-11-05

Systemic reaction (other): slight sore throat, sniffles, (negative COVID-19 test)

2022-11-06

Systemic reaction (other): slight sire throat, sniffles - COVID-19 test neg

Release 12 — day 7, dose 5

2022-11-07

Systemic reaction (other): still have sniffles, rash is like a bunch of pimples that itch like mad

Release 12 — day 21, dose 5

2022-11-23

Symptoms: I have a rash that has not gone away, and moves to different spots on my back.

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

FieldPreferred term2021-092023-042024-11
SDBody temperature increased ✓ ✓ ✓
SDDry skin ✓ · ✓
SDErythema ✓ ✓ ✓
SDHeadache · · ✓
SDInduration · · ✓
SDInjection site pruritus ✓ ✓ ✓
SDInjection site scab ✓ ✓ ✓
SDInjection site swelling · · ✓
SDMalaise ✓ · ✓
SDPain in extremity · · ✓
SDPeripheral swelling · · ✓
SDPre-existing disease · · ✓
SDPruritus ✓ ✓ ✓
SDPyrexia ✓ · ✓
SDRash ✓ ✓ ✓
SDRash erythematous ✓ ✓ ✓
SDRash pruritic · · ✓
SDScab · · ✓
SDSelf-medication ✓ ✓ ✓
SDSkin lesion ✓ ✓ ✓
SROAcne · · ✓
SROAdverse reaction ✓ ✓ ✓
SROCondition aggravated ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SROHot flush ✓ ✓ ✓
SROInjection site discharge ○ ✓ ○
SROInjection site reaction ✓ · ✓
SROInjection site vesicles ✓ · ✓
SRONight sweats ✓ ✓ ✓
SROOropharyngeal pain ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓
SRORash pruritic · · ✓
SRORhinorrhoea · · ✓
SROSARS-CoV-2 test negative · · ✓
SROScratch ✓ · ✓
SROSelf-medication ✓ ✓ ✓
SROTinnitus · · ✓

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

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