56F-26613-60171

2 vaccinations 9 coded responses 25 check-ins 9 free-text entries 0 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 857 / AZ
Registered: 2021-03-27

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

2021-03-26
Dose 1 — Moderna
2021-03-27
Registered in v-safe
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-28
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary pain — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea

Free text: Pain in the armpit area of shot arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Survey response — days 1–6 daily, dose 1
MedDRA: Ear pain — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Ear ache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-31
Survey response — days 1–6 daily, dose 1
MedDRA: Diarrhoea, Fatigue, Insomnia — Feeling: Good · Fever · Fatigue or tiredness, Diarrhea

Free text: Fatigue/tiredness in addition to insomnia, diarrhea actually getting more firm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-04
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-09
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-23
Dose 2 — Moderna
2021-04-23
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness

Adult check-in
2021-04-24
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: The symptoms started about 30 mins after yesterday's health check

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Also insomnia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Insomnia — Feeling: Fair · Site: Pain, Itching · Fever · Fatigue or tiredness

Free text: Insomnia. As tired asci am feom this i cant get to slwep and if i do i dont stay asleep for more than 2hrs at a time

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia — Feeling: Fair · Site: Pain

Free text: Trouble staying asleep

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia — Feeling: Good

Free text: Not sleeping

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — days 1–6 daily, dose 2
MedDRA: Initial insomnia, Middle insomnia, Poor quality sleep, Restlessness — Feeling: Good

Free text: Not falling to sleep, not sleeping good once asleep, restlessness, waking up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-07
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-28
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-23
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-24
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-23
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-26	Moderna
2	2021-04-23	Moderna

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-28

Systemic reaction (other): Pain in the armpit area of shot arm

2021-03-29

Systemic reaction (other): Ear ache

2021-03-31

Systemic reaction (other): Fatigue/tiredness in addition to insomnia, diarrhea actually getting more firm

Release 7 — days 1–6 daily, dose 2

2021-04-24

Systemic reaction (other): The symptoms started about 30 mins after yesterday's health check

2021-04-25

Systemic reaction (other): Also insomnia

Release 8 — days 1–6 daily, dose 2

2021-04-26

Systemic reaction (other): Insomnia. As tired asci am feom this i cant get to slwep and if i do i dont stay asleep for more than 2hrs at a time

2021-04-27

Systemic reaction (other): Trouble staying asleep

2021-04-28

Systemic reaction (other): Not sleeping

2021-04-29

Systemic reaction (other): Not falling to sleep, not sleeping good once asleep, restlessness, waking up

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
SRO	Adverse reaction	✓	✓	✓
SRO	Axillary pain	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Initial insomnia	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Middle insomnia	✓	✓	✓
SRO	Poor quality sleep	✓	✓	✓
SRO	Restlessness	✓	✓	✓

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