57P-20054-82970

6 vaccinations 32 coded responses 63 check-ins 23 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 786 / TX
Registered: 2021-03-09

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

Timeline

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

2021-03-03
Dose 1 — Moderna
2021-03-09
Registered in v-safe
2021-03-09
Survey response — days 1–6 daily, dose 1
MedDRA: Irritability — Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: irritability

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-17
Survey response — day 14, dose 1
MedDRA: Arthritis, Injection site nodule, Injection site pruritus, Injection site swelling — Feeling: Fair · Be unable to do your normal daily activities

Free text: Severe itching, swelling and hardness at vaccination site, Also, arthritis reaction like the Type 3 serum reactions I have to insect stings.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-01
Dose 2 — Moderna
2021-04-02
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Vaccination site discomfort — Feeling: Good

Free text: The tiny bit of soreness at vaccination site doesnt qualify as pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — day 7, dose 2
MedDRA: Arthralgia, Arthritis, Hypersensitivity — Feeling: Good · Site: Pain · Joint pains · Be unable to do your normal daily activities

Free text: The joint pain noted above is very mild and is from the first dose, no worse since second. Its from a Type 3 systemic allergic reaction of arthritis that occurred on 8th night after first dose.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — day 14, dose 2
MedDRA: Arthralgia, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: An old hip injury, that seldom bothered me, has ached a little since second shot, and its worse the past couple of days possibly due to rainy weather that never before set off my aches.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-01
Survey response — 3 months, dose 2
MedDRA: Allergy to arthropod sting, Hypersensitivity, Pruritus, Skin reaction, Urticaria — Feeling: Good

Free text: Not sure but typical Type 3 systemic delayed allergic response to insect stings/bites may be magnified. Bigger, itchier welts from mosquito bites form quickly. I treated heavily quickly, which mosquito never previously need, If arthritis later

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-30
Survey response — 6 months, dose 2
MedDRA: Arthritis, Arthropod bite, Condition aggravated, Pre-existing disease, Pruritus, Urticaria — Feeling: Fair

Free text: Slightly stronger response to insect bites. Mosquitoes make a welt and itch more, but it goes away. I havent been stung by anything more serious like yellowjacket or scorpion, which give me the same response as vaccine: arthritis wild itching swe

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Dose 3 — Moderna
2021-11-06
Survey response — days 1–6 daily, dose 3
MedDRA: Agitation, Delirium, Insomnia — Feeling: Good · Site: Pain, Itching

Free text: CNS excitability and insomnia onsetvat sundown that night and the next, yet not much loss of focus in daytime despite no sleep.

MedDRA releases: 2024-11 · check-in free text available
2021-11-08
Survey response — days 1–6 daily, dose 3
MedDRA: Nasal congestion — Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activities

Free text: Stuffy nose

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-10
Health check-in — day 7, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-11-17
Survey response — day 14, dose 3
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Tired without any other reason.

MedDRA releases: 2024-11 · check-in free text available
2021-11-24
Survey response — day 21, dose 3
MedDRA: Asthenia, Decreased interest, Disturbance in attention — Feeling: Good · Be unable to do your normal daily activities

Free text: Still lacking energy , as reported before, and focus , but now there's proof. I was always previously enthusiastic about cooking Thanksgiving feast. This year I could barely goer going to make only one dish and made a mess of it

MedDRA releases: 2024-11 · check-in free text available
2021-12-01
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-08
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-15
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-02
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-04
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-06-21
Dose 4 — Moderna
2022-06-22
Survey response — days 1–6 daily, dose 4
MedDRA: Bradyphrenia, Daydreaming, Speech disorder — Feeling: Good · Site: Pain, Swelling · Joint pains

Free text: moderately more absent-minded than usual. Twice as slow at Sudoku than usual. Speech mildly more rambling and less concise.

MedDRA releases: 2024-11 · check-in free text available
2022-06-23
Survey response — days 1–6 daily, dose 4
MedDRA: Bradyphrenia, Disturbance in attention, Mental status changes — Feeling: Good · Site: Pain, Swelling · Joint pains, Rash, not including the immediate area around the injection site

Free text: mental: not as poor focus and slow at sudoku as yesterday but still below par

MedDRA releases: 2024-11 · check-in free text available
2022-06-24
Survey response — days 1–6 daily, dose 4
MedDRA: Disturbance in attention, Insomnia, Pruritus, Self-medication — Feeling: Fair · Site: Pain, Swelling, Itching · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: mental focus is a little wirse than yesterday due to lack if skeep from itching and Benadryl

MedDRA releases: 2024-11 · check-in free text available
2022-06-26
Survey response — days 1–6 daily, dose 4
MedDRA: Brain fog, Mental impairment — Feeling: Good · Site: Pain

Free text: Mental was still slow yesterday but better than previous and it's negligible today - that is tiny bit of brain fog today.Yesterday I didn't report because had internet interference.

MedDRA releases: 2024-11 · check-in free text available
2022-06-27
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-06-30
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-07-05
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-07-12
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-07-19
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-07-26
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-08-02
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-09-21
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-12
Dose 5 — Moderna
2022-10-13
Survey response — days 1–6 daily, dose 5
MedDRA: Cognitive disorder, Nervous system disorder, Ocular hyperaemia, Self-medication — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: 1) red eyes 2) mental/neurological: much slower and many more errors thannusual completing Sudoko at the same level I do every day. Couldn't think how to handle a minor situation.3) I took benadryl last night which surely mitigated allergic reaction

MedDRA releases: 2024-11 · check-in free text available
2022-10-14
Survey response — days 1–6 daily, dose 5
MedDRA: Bradykinesia, Mental impairment — Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to do your normal daily activities

Free text: mental acuity not as impaired as yesterday but still noticeable . Physically not fatigued but very slow

MedDRA releases: 2024-11 · check-in free text available
2022-10-15
Survey response — days 1–6 daily, dose 5
MedDRA: Arthritis, Hypersensitivity, Self-medication — Feeling: Good · Site: Pain · Be unable to do your normal daily activities

Free text: I'm continuing to take 2 benadryl at bedtime to prevent the reaction I had before: Type 3 allergic reaction delayed systemic inflammatory arthritis.

MedDRA releases: 2024-11 · check-in free text available
2022-10-16
Survey response — days 1–6 daily, dose 5
MedDRA: Agitation, Drug hypersensitivity, Immunisation reaction, Self-medication — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Makes me more drug sensitive: dopier day after 2 benadryl; I forgot this reCtion snd had my usual 3 coffees yesterday and it made me very antsy.. I'm continuing to take benadryl for reaction I had with 1st and 4th vax

MedDRA releases: 2024-11 · check-in free text available
2022-10-17
Survey response — days 1–6 daily, dose 5
MedDRA: Arthropod bite, Pruritus, Reaction to previous exposure to any vaccine — Feeling: Good

Free text: Mosquito bites itch worse than usual, same as fir a couple of werks after previous covid vaccination

MedDRA releases: 2024-11 · check-in free text available
2022-10-18
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-19
Survey response — day 7, dose 5
MedDRA: Arthropod bite, Pruritus — Feeling: Good

Free text: The increased itching from mosquito bite I reported earlier is already hone.

MedDRA releases: 2024-11 · check-in free text available
2022-10-26
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-11-02
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-09
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-16
Survey response — day 35, dose 5
MedDRA: Eye discharge, Eye irritation, Hypersensitivity, Nasal dryness, Pre-existing disease — Feeling: Good

Free text: It has been ongoing but I just realized it may be significant. My allergies are worse for no apparent reason. irritated, gummy eyes and slight but constant nasal drip, yet it's not cedar season and no pollen or mold count is high.

MedDRA releases: 2024-11 · check-in free text available
2022-11-25
Survey response — day 42, dose 5
MedDRA: Arthritis, Fatigue, Loss of personal independence in daily activities — Feeling: Fair · Be unable to do your normal daily activities

Free text: Arthritis all over for no apparent reason lasted one day then disappeared. Tired that day for no reason. It limited my daily activity to about 15% but did not completely stop all. Next morning I was fine.

MedDRA releases: 2024-11 · check-in free text available
2023-01-12
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-04-12
Survey response — 6 months, dose 5
MedDRA: Gingival swelling, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-04-12
Report sent to call center — 6 months, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2023-04-13
Call 1 — Left Voicemail
2023-05-08
Dose 6 — Moderna
2023-05-09
Survey response — days 1–6 daily, dose 6
MedDRA: Arthritis, Brain fog, Hypersensitivity, Pre-existing disease — Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-05-10
Survey response — days 1–6 daily, dose 6
MedDRA: Adverse reaction, Brain fog — Feeling: Fair · Site: Pain, Swelling, Itching · Joint pains, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-05-11
Survey response — days 1–6 daily, dose 6
MedDRA: Pruritus, Self-medication, Somnolence — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-05-12
Survey response — days 1–6 daily, dose 6
MedDRA: Anxiety — Feeling: Fair · Site: Pain · Joint pains · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-05-13
Survey response — days 1–6 daily, dose 6
MedDRA: Hypersensitivity, Pain, Pre-existing disease, Rash — Feeling: Fair · Site: Pain · Joint pains, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-05-14
Survey response — days 1–6 daily, dose 6
MedDRA: Eye irritation, Lacrimation increased, Self-medication — Feeling: Fair · Site: Itching · Joint pains, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-05-15
Survey response — day 7, dose 6
MedDRA: Vision blurred — Feeling: Good · Rash, not including the immediate area around the injection site

MedDRA releases: 2024-11
2023-05-22
Health check-in — day 14, dose 6
Feeling: Fair

Adult check-in
2023-05-29
Survey response — day 21, dose 6
MedDRA: Apathy, Asthenia, Fatigue, Sluggishness — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-06-05
Health check-in — day 28, dose 6
Feeling: Good

Adult check-in
2023-06-12
Health check-in — day 35, dose 6
Feeling: Good

Adult check-in
2023-06-19
Health check-in — day 42, dose 6
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Moderna
2	2021-04-01	Moderna
3	2021-11-03	Moderna	No
4	2022-06-21	Moderna	No
5	2022-10-12	Moderna	No
6	2023-05-08	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-09

Systemic reaction (other): irritability

Release 5 — day 14, dose 1

2021-03-17

Symptoms: Severe itching, swelling and hardness at vaccination site, Also, arthritis reaction like the Type 3 serum reactions I have to insect stings.

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): The tiny bit of soreness at vaccination site doesnt qualify as pain.

Release 7 — day 7, dose 2

2021-04-10

Systemic reaction (other): The joint pain noted above is very mild and is from the first dose, no worse since second. Its from a Type 3 systemic allergic reaction of arthritis that occurred on 8th night after first dose.

Release 7 — day 14, dose 2

2021-04-15

Symptoms: An old hip injury, that seldom bothered me, has ached a little since second shot, and its worse the past couple of days possibly due to rainy weather that never before set off my aches.

Release 9 — 3 months, dose 2

2021-07-01

Symptoms: Not sure but typical Type 3 systemic delayed allergic response to insect stings/bites may be magnified. Bigger, itchier welts from mosquito bites form quickly. I treated heavily quickly, which mosquito never previously need, If arthritis later

Release 9 — 6 months, dose 2

2021-09-30

Symptoms: Slightly stronger response to insect bites. Mosquitoes make a welt and itch more, but it goes away. I havent been stung by anything more serious like yellowjacket or scorpion, which give me the same response as vaccine: arthritis wild itching swe

Release 10 — days 1–6 daily, dose 3

2021-11-06

Systemic reaction (other): CNS excitability and insomnia onsetvat sundown that night and the next, yet not much loss of focus in daytime despite no sleep.

2021-11-08

Systemic reaction (other): Stuffy nose

Release 10 — day 14, dose 3

2021-11-17

Symptoms: Tired without any other reason.

Release 10 — day 21, dose 3

2021-11-24

Symptoms: Still lacking energy , as reported before, and focus , but now there's proof. I was always previously enthusiastic about cooking Thanksgiving feast. This year I could barely goer going to make only one dish and made a mess of it

Release 12 — days 1–6 daily, dose 4

2022-06-22

Systemic reaction (other): moderately more absent-minded than usual. Twice as slow at Sudoku than usual. Speech mildly more rambling and less concise.

2022-06-23

Systemic reaction (other): mental: not as poor focus and slow at sudoku as yesterday but still below par

2022-06-24

Systemic reaction (other): mental focus is a little wirse than yesterday due to lack if skeep from itching and Benadryl

2022-06-26

Systemic reaction (other): Mental was still slow yesterday but better than previous and it's negligible today - that is tiny bit of brain fog today.Yesterday I didn't report because had internet interference.

Release 12 — days 1–6 daily, dose 5

2022-10-13

Systemic reaction (other): 1) red eyes 2) mental/neurological: much slower and many more errors thannusual completing Sudoko at the same level I do every day. Couldn't think how to handle a minor situation.3) I took benadryl last night which surely mitigated allergic reaction cut off by CDC

2022-10-14

Systemic reaction (other): mental acuity not as impaired as yesterday but still noticeable . Physically not fatigued but very slow

2022-10-15

Systemic reaction (other): I'm continuing to take 2 benadryl at bedtime to prevent the reaction I had before: Type 3 allergic reaction delayed systemic inflammatory arthritis.

2022-10-16

Systemic reaction (other): Makes me more drug sensitive: dopier day after 2 benadryl; I forgot this reCtion snd had my usual 3 coffees yesterday and it made me very antsy.. I'm continuing to take benadryl for reaction I had with 1st and 4th vax

2022-10-17

Systemic reaction (other): Mosquito bites itch worse than usual, same as fir a couple of werks after previous covid vaccination

Release 12 — day 7, dose 5

2022-10-19

Systemic reaction (other): The increased itching from mosquito bite I reported earlier is already hone.

Release 12 — day 35, dose 5

2022-11-16

Symptoms: It has been ongoing but I just realized it may be significant. My allergies are worse for no apparent reason. irritated, gummy eyes and slight but constant nasal drip, yet it's not cedar season and no pollen or mold count is high.

Release 12 — day 42, dose 5

2022-11-25

Symptoms: Arthritis all over for no apparent reason lasted one day then disappeared. Tired that day for no reason. It limited my daily activity to about 15% but did not completely stop all. Next morning I was fine.

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
HCVO	Office visit	·	·	✓
SD	Allergy to arthropod sting	·	·	✓
SD	Apathy	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Arthritis	✓	✓	✓
SD	Arthropod bite	·	·	✓
SD	Asthenia	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Decreased interest	·	·	✓
SD	Disturbance in attention	·	·	✓
SD	Eye discharge	·	·	✓
SD	Eye irritation	·	·	✓
SD	Fatigue	·	·	✓
SD	Gingival swelling	·	·	✓
SD	Hypersensitivity	✓	✓	✓
SD	Injection site nodule	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Loss of personal independence in daily activities	·	·	✓
SD	Nasal dryness	·	·	✓
SD	Office visit	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pruritus	·	·	✓
SD	Skin reaction	·	·	✓
SD	Sluggishness	·	·	✓
SD	Urticaria	·	·	✓
SRO	Adverse reaction	·	·	✓
SRO	Agitation	·	·	✓
SRO	Anxiety	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Arthritis	✓	✓	✓
SRO	Arthropod bite	·	·	✓
SRO	Bradykinesia	·	·	✓
SRO	Bradyphrenia	·	·	✓
SRO	Brain fog	·	·	✓
SRO	Cognitive disorder	·	·	✓
SRO	Daydreaming	·	·	✓
SRO	Delirium	·	·	✓
SRO	Disturbance in attention	·	·	✓
SRO	Drug hypersensitivity	·	·	✓
SRO	Eye irritation	·	·	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Immunisation reaction	·	·	✓
SRO	Insomnia	·	·	✓
SRO	Irritability	✓	✓	✓
SRO	Lacrimation increased	·	·	✓
SRO	Mental impairment	·	·	✓
SRO	Mental status changes	·	·	✓
SRO	Nasal congestion	·	·	✓
SRO	Nervous system disorder	·	·	✓
SRO	Ocular hyperaemia	·	·	✓
SRO	Pain	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Pruritus	·	·	✓
SRO	Rash	·	·	✓
SRO	Reaction to previous exposure to any vaccine	·	·	✓
SRO	Self-medication	·	·	✓
SRO	Somnolence	·	·	✓
SRO	Speech disorder	·	·	✓
SRO	Vaccination site discomfort	✓	✓	✓
SRO	Vision blurred	·	·	✓

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