53G-94471-39470

4 vaccinations 4 coded responses 41 check-ins 3 free-text entries 0 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 347 / FL
Registered: 2021-03-29

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

2021-03-15
Dose 1 — Moderna
2021-03-29
Registered in v-safe
2021-03-29
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site pain, Injection site rash, Injection site swelling, Rash pruritic — Feeling: Good

Free text: Initially there was minor pain for two days at injection site. Then swelling, redness and an itchy rash for five days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-12
Dose 2 — Moderna
2021-04-12
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · Headache

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-04-19
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-12
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-11
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-15
Dose 3 — Moderna
2022-01-21
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Fatigue, Headache, Myalgia — Feeling: Good · Site: Itching

Free text: I had the booster shot six days ago. I did have multiple symptoms for three days: headache, muscle aches,fatigue, soreness under my arms. I was unable to complete my normal daily routine the day after the booster. My symptoms gradually lessened.

MedDRA releases: 2024-11 · check-in free text available
2022-01-22
Health check-in — day 7, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2022-01-29
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-02-05
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-02-12
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-02-19
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-26
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-04-18
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-07-16
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-12-05
Dose 4 — Moderna
2022-12-05
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-12-06
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-12-07
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-12-08
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Redness, Swelling · Headache

Adult check-in
2022-12-09
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness · None

Adult check-in
2022-12-10
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness · None

Adult check-in
2022-12-11
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness · None

Adult check-in
2022-12-12
Health check-in — day 7, dose 4
Feeling: Good · Site: Redness · None

Adult check-in
2022-12-19
Survey response — day 14, dose 4
MedDRA: Fatigue — Feeling: Good

Free text: I've had intermittent periods of minor fatigue.

MedDRA releases: 2024-11 · check-in free text available
2022-12-27
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2023-01-02
Survey response — day 28, dose 4
MedDRA: Chills, Cough, Fatigue, Nasal congestion, SARS-CoV-2 test negative, Sinus pain — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-01-09
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2023-01-16
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-03-06
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-06-05
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-15	Moderna
2	2021-04-12	Moderna
3	2022-01-15	Moderna	No
4	2022-12-05	Moderna	No

Free text

Release 6 — day 14, dose 1

2021-03-29

Symptoms: Initially there was minor pain for two days at injection site. Then swelling, redness and an itchy rash for five days.

Release 11 — days 1–6 daily, dose 3

2022-01-21

Systemic reaction (other): I had the booster shot six days ago. I did have multiple symptoms for three days: headache, muscle aches,fatigue, soreness under my arms. I was unable to complete my normal daily routine the day after the booster. My symptoms gradually lessened.

Release 12 — day 14, dose 4

2022-12-19

Symptoms: I've had intermittent periods of minor fatigue.

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	Chills	·	·	✓
SD	Cough	·	·	✓
SD	Fatigue	·	·	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Nasal congestion	·	·	✓
SD	Rash pruritic	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sinus pain	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Fatigue	·	·	✓
SRO	Headache	·	·	✓
SRO	Myalgia	·	·	✓

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