52S-31754-25088

3 vaccinations 10 coded responses 23 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 334 / FL
Registered: 2021-01-31

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

Timeline

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

2021-01-31
Registered in v-safe
2021-01-31
Dose 1 — Moderna
2021-01-31
Survey response — day 0, dose 1
MedDRA: Pruritus — Feeling: Good · Chills

Free text: Itchy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Rash, not including the immediate area around the injection site

Adult check-in
2021-02-02
Survey response — days 1–6 daily, dose 1
MedDRA: Rash, Rash pruritic — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Rash, not including the immediate area around the injection site

Free text: I have an itchy rash on the inside of both my arms and my face

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus — Feeling: Good · Site: Redness, Itching · Rash, not including the immediate area around the injection site

Free text: Itching on my head and my legs and Im just concerned about the second shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — days 1–6 daily, dose 1
MedDRA: Erythema — Feeling: Good · Site: Pain, Redness · Rash, not including the immediate area around the injection site

Free text: I just see that under my skin theres red watches its not hives its not itchy its just red watches and I need to know if I can take the second vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-07
Survey response — day 7, dose 1
MedDRA: Pain in extremity, Peripheral swelling — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: My hands are swollen and hurting every morning

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — day 14, dose 1
MedDRA: Rash — Feeling: Fair

Free text: I have no rash on my arm two weeks later now I have a huge rash on my arm from the vaccine

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

Adult check-in
2021-02-28
Dose 2 — Moderna
2021-02-28
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Fever · Fatigue or tiredness, Abdominal pain · Be unable to work

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Itching · Fever · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Chills, Abdominal pain

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Gait disturbance, Sensory disturbance — Feeling: Fair · Joint pains

Free text: Its very hard to walk my muscles in my legs feel like theyre pulling Im trying to walk I have to stop it almost feels like my muscles are being polled

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-07
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-14
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-21
Survey response — day 21, dose 2
MedDRA: Influenza like illness, Lymphadenopathy, Oropharyngeal pain, Pain — Feeling: Fair

Free text: I have really bad bodyaches ImA sore throat and just an overall feeling of having the flu mildly And really bad swollen glands

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-08-29
Survey response — 6 months, dose 2
MedDRA: Pre-existing disease, Psoriasis, Skin irritation — Feeling: Fair · Be unable to do your normal daily activities

Free text: My psoriasis. A small pack has doubled in size its al its also extremely irritated this only happened since the vaccine

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-12-18
Dose 3 — Moderna
2022-02-28
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-06-18
Survey response — 6 months, dose 3
MedDRA: COVID-19 — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Covid-19

MedDRA releases: 2024-11 · check-in free text available
2022-06-18
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-06-21
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-31	Moderna
2	2021-02-28	Moderna
3	2021-12-18	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 3 — day 0, dose 1

2021-01-31

Systemic reaction (other): Itchy

Release 3 — days 1–6 daily, dose 1

2021-02-02

Systemic reaction (other): I have an itchy rash on the inside of both my arms and my face

2021-02-04

Systemic reaction (other): Itching on my head and my legs and Im just concerned about the second shot

2021-02-05

Systemic reaction (other): I just see that under my skin theres red watches its not hives its not itchy its just red watches and I need to know if I can take the second vaccine

Release 3 — day 7, dose 1

2021-02-07

Systemic reaction (other): My hands are swollen and hurting every morning

Release 4 — day 14, dose 1

2021-02-14

Symptoms: I have no rash on my arm two weeks later now I have a huge rash on my arm from the vaccine

Release 5 — days 1–6 daily, dose 2

2021-03-04

Systemic reaction (other): Its very hard to walk my muscles in my legs feel like theyre pulling Im trying to walk I have to stop it almost feels like my muscles are being polled

Release 6 — day 21, dose 2

2021-03-21

Symptoms: I have really bad bodyaches ImA sore throat and just an overall feeling of having the flu mildly And really bad swollen glands

Release 9 — 6 months, dose 2

2021-08-29

Symptoms: My psoriasis. A small pack has doubled in size its al its also extremely irritated this only happened since the vaccine

Release 12 — 6 months, dose 3

2022-06-18

Symptoms: Covid-19

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	COVID-19	·	·	✓
SD	Influenza like illness	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	✓	·	✓
SD	Psoriasis	✓	·	✓
SD	Rash	✓	✓	✓
SD	Skin irritation	✓	·	✓
SRO	Erythema	✓	✓	✓
SRO	Gait disturbance	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash pruritic	✓	✓	✓
SRO	Sensory disturbance	✓	✓	✓

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