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54A-18439-50803

5 vaccinations 23 coded responses 67 check-ins 23 free-text entries 1 call case
Sex
Female
Age at first dose
51-55
ZIP prefix
949 / CA
Registered
2021-04-28
Relationship
Self
Race
White
Ethnicity
N/A

Timeline

  1. 2021-04-28
    Registered in v-safe
  2. 2021-04-28
    Dose 1 — Moderna
  3. 2021-04-28
    Health check-in — day 0, dose 1
    Feeling: Fair · Headache
    Adult check-in
  4. 2021-04-29
    Survey response — days 1–6 daily, dose 1
    MedDRA: Blood glucose increased — Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities
    Free text: High Blood Sugars (above 400)
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-04-30
    Survey response — days 1–6 daily, dose 1
    MedDRA: Inflammation, Injection site erythema, Injection site induration, Injection site swelling, Insomnia, Migraine, Nausea, Pain in extremity, Self-medication — Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Free text: New symptoms started last night: L arm inflammation. Bright red at and surrounding area of injection site with severe pain extending throughout entire left arm. Unable to sleep due to pain and hard swelling surrounding injection site. Nauseated with migraine since yesterday. Ibuprofen did not help.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-05-01
    Survey response — days 1–6 daily, dose 1
    MedDRA: Chills, Injection site erythema, Injection site inflammation, Injection site pain, Lethargy — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Free text: Injection site still very red and inflamed, painful. Pain radiates down arm. Lethargic and chills.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-05-02
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Adult check-in
  8. 2021-05-03
    Health check-in — days 1–6 daily, dose 1
    Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Adult check-in
  9. 2021-05-04
    Health check-in — days 1–6 daily, dose 1
    Feeling: Poor · Site: Pain, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Adult check-in
  10. 2021-05-05
    Health check-in — day 7, dose 1
    Feeling: Poor · Site: Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Adult check-in
  11. 2021-05-12
    Survey response — day 14, dose 1
    MedDRA: Blood glucose increased, Fatigue, Injection site erythema, Injection site induration, Injection site rash, Injection site warmth — Feeling: Fair · Be unable to do your normal daily activities
    Free text: The red rash around the injection site has not subsided. It is still very red, large, hot, hard, raised, and itchy. Is this normal? Did the vaccine not reach the muscle? Extremely high blood sugars and excessive fatigue as well.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-05-19
    Survey response — day 21, dose 1
    MedDRA: Abdominal pain, Arthralgia, Injection site erythema, Injection site pain, Injection site swelling, Lethargy, Nausea — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Still have redness and swelling, pain at and around injection site. Abdominal pain. Joint pain. Lethargic and nauseous. I worry about getting the second shot next week. Will side effects be even worse and last even longer?
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-05-26
    Dose 2 — Moderna
  14. 2021-05-26
    Health check-in — day 0, dose 2
    Feeling: Fair · Site: Pain, Redness · Headache, Fatigue or tiredness
    Adult check-in
  15. 2021-05-27
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities
    Adult check-in
  16. 2021-05-28
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities
    Adult check-in
  17. 2021-05-29
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities
    Adult check-in
  18. 2021-05-30
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Adult check-in
  19. 2021-05-31
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities
    Adult check-in
  20. 2021-06-01
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities
    Adult check-in
  21. 2021-06-02
    Health check-in — day 7, dose 2
    Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities
    Adult check-in
  22. 2021-06-09
    Health check-in — day 14, dose 2
    Feeling: Fair
    Adult check-in
  23. 2021-06-16
    Survey response — day 21, dose 2
    MedDRA: Fatigue, Insomnia, Nausea — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Nausea, Fatigue, Insomnia
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  24. 2021-06-23
    Survey response — day 28, dose 2
    MedDRA: Headache, Nausea — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Increased nausea and headaches
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  25. 2021-06-30
    Survey response — day 35, dose 2
    MedDRA: Blood glucose increased, Dehydration, Diabetes mellitus, Headache, Lethargy, Pre-existing disease, Staphylococcal infection — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Staff Infection on R shoulder. Dehydration, headaches, and extremely high blood sugars above 600+. (Type I Diabetic) Lethargic 24/7.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  26. 2021-07-07
    Survey response — day 42, dose 2
    MedDRA: Blood glucose increased, Lethargy — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Increased lethargy and blood sugars above 600 daily for past few weeks.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  27. 2021-08-25
    Health check-in — 3 months, dose 2
    Feeling: Fair
    Adult check-in
  28. 2021-11-25
    Health check-in — 6 months, dose 2
    Feeling: Fair
    Adult check-in
  29. 2021-12-16
    Dose 3 — Moderna
  30. 2021-12-16
    Survey response — day 0, dose 3
    MedDRA: Blood glucose increased — Feeling: Fair · Site: Pain, Redness · Headache, Fatigue or tiredness
    Free text: High Blood Sugar Spike (above 550)
    MedDRA releases: 2024-11 · check-in free text available
  31. 2021-12-17
    Survey response — days 1–6 daily, dose 3
    MedDRA: Blood glucose increased — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Extremely high blood sugars
    MedDRA releases: 2024-11 · check-in free text available
  32. 2021-12-18
    Health check-in — days 1–6 daily, dose 3
    Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  33. 2021-12-20
    Health check-in — days 1–6 daily, dose 3
    Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  34. 2021-12-21
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities
    Adult check-in
  35. 2021-12-22
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  36. 2021-12-23
    Survey response — day 7, dose 3
    MedDRA: Dizziness — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Severe dizziness
    MedDRA releases: 2024-11 · check-in free text available
  37. 2021-12-30
    Health check-in — day 14, dose 3
    Feeling: Fair
    Adult check-in
  38. 2022-01-06
    Health check-in — day 21, dose 3
    Feeling: Fair
    Adult check-in
  39. 2022-01-13
    Survey response — day 28, dose 3
    MedDRA: Blood glucose increased, Fatigue, Migraine — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Severe fatigue and migraines daily. Blood sugars above 500 daily.
    MedDRA releases: 2024-11 · check-in free text available
  40. 2022-01-20
    Survey response — day 35, dose 3
    MedDRA: Migraine — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Severe Migraines
    MedDRA releases: 2024-11 · check-in free text available
  41. 2022-01-27
    Survey response — day 42, dose 3
    MedDRA: Blood glucose increased, Fatigue, Migraine — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Daily Migraines and extremely high blood sugars over 500+. Severe fatigue.
    MedDRA releases: 2024-11 · check-in free text available
  42. 2022-03-17
    Health check-in — 3 months, dose 3
    Feeling: Fair
    Adult check-in
  43. 2022-05-04
    Dose 4 — Moderna
  44. 2022-05-04
    Health check-in — day 0, dose 4
    Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness
    Adult check-in
  45. 2022-05-05
    Health check-in — days 1–6 daily, dose 4
    Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Adult check-in
  46. 2022-05-06
    Survey response — days 1–6 daily, dose 4
    MedDRA: Blood glucose increased — Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Free text: Extremely high blood sugars over 500
    MedDRA releases: 2024-11 · check-in free text available
  47. 2022-05-07
    Health check-in — days 1–6 daily, dose 4
    Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Adult check-in
  48. 2022-05-08
    Health check-in — days 1–6 daily, dose 4
    Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Adult check-in
  49. 2022-05-09
    Health check-in — days 1–6 daily, dose 4
    Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  50. 2022-05-10
    Health check-in — days 1–6 daily, dose 4
    Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Adult check-in
  51. 2022-05-11
    Health check-in — day 7, dose 4
    Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  52. 2022-05-18
    Health check-in — day 14, dose 4
    Feeling: Poor
    Adult check-in
  53. 2022-05-25
    Health check-in — day 21, dose 4
    Feeling: Fair
    Adult check-in
  54. 2022-06-02
    Health check-in — day 28, dose 4
    Feeling: Fair
    Adult check-in
  55. 2022-06-08
    Health check-in — day 35, dose 4
    Feeling: Fair
    Adult check-in
  56. 2022-06-15
    Survey response — day 42, dose 4
    MedDRA: Blood glucose increased, Diabetes mellitus, Insomnia, Lethargy, Migraine, Pre-existing disease — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Extreme high blood sugars (Type 1 Diabetic). Lethargic. Insomnia every night. Migraines.
    MedDRA releases: 2024-11 · check-in free text available
  57. 2022-08-03
    Survey response — 3 months, dose 4
    MedDRA: Blood glucose increased, Migraine — 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
    Free text: Higher blood sugars daily (above 500). Also increased migraines.
    MedDRA releases: 2024-11 · check-in free text available
  58. 2022-08-03
    Report sent to call center — 3 months, dose 4
    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 · 1 call case(s)
  59. 2022-08-04
  60. 2022-11-01
    Dose 5 — Moderna
  61. 2022-11-01
    Survey response — day 0, dose 5
    MedDRA: Blood glucose increased — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities
    Free text: High blood sugars above 500
    MedDRA releases: 2024-11 · check-in free text available
  62. 2022-11-02
    Survey response — days 1–6 daily, dose 5
    MedDRA: Blood glucose increased, Unevaluable event — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities
    Free text: High Blood Sugars (Type I)
    MedDRA releases: 2024-11 · check-in free text available
  63. 2022-11-03
    Health check-in — days 1–6 daily, dose 5
    Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  64. 2022-11-04
    Survey response — days 1–6 daily, dose 5
    MedDRA: Blood glucose increased — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: High Blood Sugars above 450
    MedDRA releases: 2024-11 · check-in free text available
  65. 2022-11-05
    Health check-in — days 1–6 daily, dose 5
    Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  66. 2022-11-06
    Health check-in — days 1–6 daily, dose 5
    Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Adult check-in
  67. 2022-11-07
    Health check-in — days 1–6 daily, dose 5
    Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  68. 2022-11-08
    Health check-in — day 7, dose 5
    Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  69. 2022-11-15
    Survey response — day 14, dose 5
    MedDRA: Blood glucose increased, Oropharyngeal pain — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Severe sore throat today and high sugars.
    MedDRA releases: 2024-11 · check-in free text available
  70. 2022-11-22
    Health check-in — day 21, dose 5
    Feeling: Fair
    Adult check-in
  71. 2022-11-29
    Survey response — day 28, dose 5
    MedDRA: Blood glucose increased, Migraine, Palpitations — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Migraines, heart palpitations, and high blood sugars above 500.
    MedDRA releases: 2024-11 · check-in free text available
  72. 2022-12-06
    Health check-in — day 35, dose 5
    Feeling: Fair
    Adult check-in
  73. 2022-12-13
    Health check-in — day 42, dose 5
    Feeling: Fair
    Adult check-in
  74. 2023-01-31
    Health check-in — 3 months, dose 5
    Feeling: Fair
    Adult check-in
  75. 2023-05-02
    Health check-in — 6 months, dose 5
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-04-28Moderna
22021-05-26Moderna
32021-12-16Moderna No
42022-05-04Moderna No
52022-11-01Moderna No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 8 — days 1–6 daily, dose 1

2021-04-29

Systemic reaction (other): High Blood Sugars (above 400)

2021-04-30

Systemic reaction (other): New symptoms started last night: L arm inflammation. Bright red at and surrounding area of injection site with severe pain extending throughout entire left arm. Unable to sleep due to pain and hard swelling surrounding injection site. Nauseated with migraine since yesterday. Ibuprofen did not help.

2021-05-01

Systemic reaction (other): Injection site still very red and inflamed, painful. Pain radiates down arm. Lethargic and chills.

Release 8 — day 14, dose 1

2021-05-12

Symptoms: The red rash around the injection site has not subsided. It is still very red, large, hot, hard, raised, and itchy. Is this normal? Did the vaccine not reach the muscle? Extremely high blood sugars and excessive fatigue as well.

Release 8 — day 21, dose 1

2021-05-19

Symptoms: Still have redness and swelling, pain at and around injection site. Abdominal pain. Joint pain. Lethargic and nauseous. I worry about getting the second shot next week. Will side effects be even worse and last even longer?

Release 9 — day 21, dose 2

2021-06-16

Symptoms: Nausea, Fatigue, Insomnia

Release 9 — day 28, dose 2

2021-06-23

Symptoms: Increased nausea and headaches

Release 9 — day 35, dose 2

2021-06-30

Symptoms: Staff Infection on R shoulder. Dehydration, headaches, and extremely high blood sugars above 600+. (Type I Diabetic) Lethargic 24/7.

Release 9 — day 42, dose 2

2021-07-07

Symptoms: Increased lethargy and blood sugars above 600 daily for past few weeks.

Release 10 — day 0, dose 3

2021-12-16

Systemic reaction (other): High Blood Sugar Spike (above 550)

Release 10 — days 1–6 daily, dose 3

2021-12-17

Systemic reaction (other): Extremely high blood sugars

Release 10 — day 7, dose 3

2021-12-23

Systemic reaction (other): Severe dizziness

Release 10 — day 28, dose 3

2022-01-13

Symptoms: Severe fatigue and migraines daily. Blood sugars above 500 daily.

Release 10 — day 35, dose 3

2022-01-20

Symptoms: Severe Migraines

Release 11 — day 42, dose 3

2022-01-27

Symptoms: Daily Migraines and extremely high blood sugars over 500+. Severe fatigue.

Release 11 — days 1–6 daily, dose 4

2022-05-06

Systemic reaction (other): Extremely high blood sugars over 500

Release 12 — day 42, dose 4

2022-06-15

Symptoms: Extreme high blood sugars (Type 1 Diabetic). Lethargic. Insomnia every night. Migraines.

Release 12 — 3 months, dose 4

2022-08-03

Symptoms: Higher blood sugars daily (above 500). Also increased migraines.

Release 12 — day 0, dose 5

2022-11-01

Systemic reaction (other): High blood sugars above 500

Release 12 — days 1–6 daily, dose 5

2022-11-02

Systemic reaction (other): High Blood Sugars (Type I)

2022-11-04

Systemic reaction (other): High Blood Sugars above 450

Release 12 — day 14, dose 5

2022-11-15

Symptoms: Severe sore throat today and high sugars.

Release 12 — day 28, dose 5

2022-11-29

Symptoms: Migraines, heart palpitations, and high blood sugars above 500.

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
SDAbdominal pain ✓ ✓ ✓
SDArthralgia ✓ ✓ ✓
SDBlood glucose increased ✓ ✓ ✓
SDDehydration ✓ ✓ ✓
SDDiabetes mellitus ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDInjection site erythema ✓ ✓ ✓
SDInjection site induration ✓ ✓ ✓
SDInjection site pain ✓ ✓ ✓
SDInjection site rash ✓ ✓ ✓
SDInjection site swelling ✓ ✓ ✓
SDInjection site warmth ✓ ✓ ✓
SDInsomnia ✓ ✓ ✓
SDLethargy ✓ ✓ ✓
SDMigraine · · ✓
SDNausea ✓ ✓ ✓
SDOropharyngeal pain · · ✓
SDPalpitations · · ✓
SDPre-existing disease ✓ ✓ ✓
SDStaphylococcal infection ✓ ✓ ✓
SROBlood glucose increased ✓ ✓ ✓
SROChills ✓ ✓ ✓
SRODizziness · · ✓
SROInflammation ✓ ✓ ✓
SROInjection site erythema ✓ ✓ ✓
SROInjection site induration ✓ ✓ ✓
SROInjection site inflammation ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SROInjection site swelling ✓ ✓ ✓
SROInsomnia ✓ ✓ ✓
SROLethargy ✓ ✓ ✓
SROMigraine ✓ ✓ ✓
SRONausea ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROSelf-medication ✓ ✓ ✓
SROUnevaluable event · · ✓

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

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