4XG-17361-13322

4 vaccinations 12 coded responses 31 check-ins 12 free-text entries 0 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 977 / OR
Registered: 2021-04-09

Relationship: Self
Race: White
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

2021-03-11
Dose 1 — Moderna
2021-04-08
Dose 2 — Moderna
2021-04-09
Registered in v-safe
2021-04-09
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 · Be unable to do your normal daily activities

Adult check-in
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Irritability, Oedema peripheral — Feeling: Good

Free text: Irritated and slightly swollen armpit on the arm where I got my injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Oedema peripheral, Skin irritation — Feeling: Good

Free text: Slight irritation and swelling in armpit of injection side arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Oedema peripheral, Skin irritation — Feeling: Good

Free text: Slightly irritated and swollen armpit on injection side

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Irritability, Oedema peripheral — Feeling: Good

Free text: Slight irritation and swelling of armpit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Irritability, Peripheral swelling — Feeling: Good

Free text: Slight irritation and swelling in the armpit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — day 7, dose 2
MedDRA: Axillary pain, Oedema peripheral — Feeling: Good

Free text: Slight irritation and swelling in armpit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-08
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-07
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-05
Dose 3 — Moderna
2022-04-08
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-22
Dose 4 — Moderna
2022-04-22
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-04-23
Survey response — days 1–6 daily, dose 4
MedDRA: Asthenia, Dizziness — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Weakness & dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-04-24
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-25
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches

Adult check-in
2022-04-26
Survey response — days 1–6 daily, dose 4
MedDRA: Oedema peripheral, Skin discolouration — Feeling: Fair · Site: Redness, Swelling · Muscle or body aches

Free text: Armpit is extremely swollen and black and blue

MedDRA releases: 2024-11 · check-in free text available
2022-04-27
Survey response — days 1–6 daily, dose 4
MedDRA: Heart rate increased, Oedema peripheral, Skin discolouration — Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches

Free text: Armpit swollen & black and blue. Heart rate higher than normal walking uphill

MedDRA releases: 2024-11 · check-in free text available
2022-04-28
Survey response — days 1–6 daily, dose 4
MedDRA: Oedema peripheral, Skin discolouration — Feeling: Fair · Site: Redness, Swelling

Free text: Swelling under my arm has gone down some. Black and blue area is also turning green today

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
Survey response — day 7, dose 4
MedDRA: Oedema peripheral, Skin discolouration — Feeling: Fair · Site: Redness, Swelling

Free text: Armpit swelling and black, blue and green discoloration is decreasing

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-13
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-20
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-27
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-03
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-22
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-21
Survey response — 6 months, dose 4
MedDRA: SARS-CoV-2 test positive — Feeling: Fair · Be unable to do your normal daily activities

Free text: Covid positive test 10/15/2022

MedDRA releases: 2024-11 · check-in free text available
2023-04-22
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-11	Moderna
2	2021-04-08	Moderna
3	2021-11-05	Moderna	No
4	2022-04-22	Moderna	No

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-10

Systemic reaction (other): Irritated and slightly swollen armpit on the arm where I got my injection

2021-04-11

Systemic reaction (other): Slight irritation and swelling in armpit of injection side arm

2021-04-12

Systemic reaction (other): Slightly irritated and swollen armpit on injection side

2021-04-13

Systemic reaction (other): Slight irritation and swelling of armpit

2021-04-14

Systemic reaction (other): Slight irritation and swelling in the armpit

Release 7 — day 7, dose 2

2021-04-15

Systemic reaction (other): Slight irritation and swelling in armpit

Release 11 — days 1–6 daily, dose 4

2022-04-23

Systemic reaction (other): Weakness & dizziness

2022-04-26

Systemic reaction (other): Armpit is extremely swollen and black and blue

2022-04-27

Systemic reaction (other): Armpit swollen & black and blue. Heart rate higher than normal walking uphill

2022-04-28

Systemic reaction (other): Swelling under my arm has gone down some. Black and blue area is also turning green today

Release 11 — day 7, dose 4

2022-04-29

Systemic reaction (other): Armpit swelling and black, blue and green discoloration is decreasing

Release 12 — 6 months, dose 4

2022-10-21

Symptoms: Covid positive test 10/15/2022

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	SARS-CoV-2 test positive	·	·	✓
SRO	Asthenia	·	·	✓
SRO	Axillary pain	✓	✓	✓
SRO	Dizziness	·	·	✓
SRO	Heart rate increased	·	·	✓
SRO	Irritability	✓	✓	✓
SRO	Oedema peripheral	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Skin discolouration	·	·	✓
SRO	Skin irritation	✓	✓	✓

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