4ZG-11028-47718

3 vaccinations 12 coded responses 37 check-ins 12 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 930 / CA
Registered: 2021-04-01

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-04-01
Registered in v-safe
2021-04-01
Dose 1 — Moderna
2021-04-01
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Fever · None

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-06
Survey response — days 1–6 daily, dose 1
MedDRA: Immediate post-injection reaction, Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Rash started immediately after getting the shot. Second and third day was the whole arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-08
Health check-in — day 7, dose 1
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-15
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-28
Dose 2 — Moderna
2021-04-28
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-29
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
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-05-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · None

Adult check-in
2021-05-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Nausea · Be unable to do your normal daily activities

Adult check-in
2021-05-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling, Itching · None

Adult check-in
2021-05-05
Health check-in — day 7, dose 2
Feeling: Good · Site: Swelling, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-05-13
Survey response — day 14, dose 2
MedDRA: Muscle spasms — Feeling: Fair

Free text: I have a cramp on my left starts on my spine to my neck across the shoulder blade to my elbow. Started 5days ago.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Survey response — day 21, dose 2
MedDRA: Dizziness, Head discomfort — Feeling: Good

Free text: Head pressure, light headed as if I got out of a roller-coaster.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Survey response — day 28, dose 2
MedDRA: Muscle spasms — Feeling: Fair

Free text: Muscle spasm/cramp on left arm and shoulder.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-11
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-30
Survey response — 3 months, dose 2
MedDRA: Oropharyngeal pain, Pharyngeal swelling — Feeling: Good

Free text: Throat hurts is a little swallowen.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-28
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-23
Dose 3 — Pfizer-BioNTech
2021-12-24
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · 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
2021-12-25
Survey response — days 1–6 daily, dose 3
MedDRA: Ear discomfort, Oropharyngeal pain — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Sore throat and ear discomfort

MedDRA releases: 2024-11 · check-in free text available
2021-12-26
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2021-12-27
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain — Feeling: Fair

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2021-12-28
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain — Feeling: Fair · Chills, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2021-12-30
Survey response — day 7, dose 3
MedDRA: Oropharyngeal pain — Feeling: Fair

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-01-08
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2022-01-13
Survey response — day 21, dose 3
MedDRA: Headache, Oropharyngeal pain, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sore throat, watery nose, nausea, headaches

MedDRA releases: 2024-11 · check-in free text available
2022-01-22
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-01-28
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-24
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-06-27
Survey response — 6 months, dose 3
MedDRA: Diverticulitis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Diverticulitis

MedDRA releases: 2024-11 · check-in free text available
2022-06-27
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-28
Call 1 — Left Voicemail
2022-12-25
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-01	Moderna
2	2021-04-28	Moderna
3	2021-12-23	Pfizer-BioNTech	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-06

Systemic reaction (other): Rash started immediately after getting the shot. Second and third day was the whole arm.

Release 8 — day 14, dose 2

2021-05-13

Symptoms: I have a cramp on my left starts on my spine to my neck across the shoulder blade to my elbow. Started 5days ago.

Release 8 — day 21, dose 2

2021-05-19

Symptoms: Head pressure, light headed as if I got out of a roller-coaster.

Release 8 — day 28, dose 2

2021-05-26

Symptoms: Muscle spasm/cramp on left arm and shoulder.

Release 9 — 3 months, dose 2

2021-07-30

Symptoms: Throat hurts is a little swallowen.

Release 10 — days 1–6 daily, dose 3

2021-12-25

Systemic reaction (other): Sore throat and ear discomfort

2021-12-26

Systemic reaction (other): Sore throat

2021-12-27

Systemic reaction (other): Sore throat

2021-12-28

Systemic reaction (other): Sore throat

Release 10 — day 7, dose 3

2021-12-30

Systemic reaction (other): Sore throat

Release 10 — day 21, dose 3

2022-01-13

Symptoms: Sore throat, watery nose, nausea, headaches

Release 12 — 6 months, dose 3

2022-06-27

Symptoms: Diverticulitis

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	Diverticulitis	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Head discomfort	✓	✓	✓
SD	Headache	·	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Oropharyngeal pain	✓	·	✓
SD	Pharyngeal swelling	✓	·	✓
SD	Rhinorrhoea	·	·	✓
SRO	Ear discomfort	·	·	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Rash	✓	✓	✓

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