5A7-13781-37097

3 vaccinations 12 coded responses 35 check-ins 12 free-text entries 0 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 024 / MA
Registered: 2021-03-09

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

2021-03-09
Registered in v-safe
2021-03-09
Dose 1 — Moderna
2021-03-09
Survey response — day 0, dose 1
MedDRA: Decreased appetite — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Loss of appetite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal pain — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Free text: Upon rising this morning had some bilateral abdominal pain, seemed like kidneys (have had stones before)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Good

Free text: Slightly light-headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Headache — Feeling: Fair · Headache

Free text: Had a significant headache overnight.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Survey response — day 7, dose 1
MedDRA: Headache — Feeling: Good · Headache

Free text: Slight headache. Note that I almost never have headaches usually so those that Ive reported are unusual.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-06
Dose 2 — Moderna
2021-04-06
Health check-in — day 0, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Palpitations — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Woke up overnight with feeling that my heart was racing, kept me awake for an hour from 4 to 5am.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-13
Survey response — day 7, dose 2
MedDRA: Dyskinesia — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Overnight last night I was awakened by my finger moving around without my controlling it, continued for a couple of hours. Never experienced that before, not sure if related to vaccination or just a random occurrence.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-08
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-06
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-27
Dose 3 — Moderna
2021-10-29
Survey response — days 1–6 daily, dose 3
MedDRA: Peripheral coldness — Feeling: Fair · Site: Pain, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Last night hands and feet were EXTREMELY cold, rest of my body was too warm. It was odd.

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Survey response — days 1–6 daily, dose 3
MedDRA: Fatigue, Pain in extremity — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Both arm pain and fatigue are much improved, very slight today.

MedDRA releases: 2024-11 · check-in free text available
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Insomnia — Feeling: Good

Free text: Insomnia past two nights, is very unusual but don't know that it's related to vaccination.

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-11
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-17
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-01
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-08
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-26
Survey response — 3 months, dose 3
MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Mild case of Covid

MedDRA releases: 2024-11 · check-in free text available
2022-04-27
Survey response — 6 months, dose 3
MedDRA: Pain in extremity — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Got extreme arm pain from recent booster - think pharmacist placed injection too high on shoulder.

MedDRA releases: 2024-11 · check-in free text available
2022-10-27
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-09	Moderna
2	2021-04-06	Moderna
3	2021-10-27	Moderna	No

Free text

Release 5 — day 0, dose 1

2021-03-09

Systemic reaction (other): Loss of appetite

Release 5 — days 1–6 daily, dose 1

2021-03-10

Systemic reaction (other): Upon rising this morning had some bilateral abdominal pain, seemed like kidneys (have had stones before)

2021-03-12

Systemic reaction (other): Slightly light-headed

2021-03-14

Systemic reaction (other): Had a significant headache overnight.

Release 5 — day 7, dose 1

2021-03-16

Systemic reaction (other): Slight headache. Note that I almost never have headaches usually so those that Ive reported are unusual.

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): Woke up overnight with feeling that my heart was racing, kept me awake for an hour from 4 to 5am.

Release 7 — day 7, dose 2

2021-04-13

Systemic reaction (other): Overnight last night I was awakened by my finger moving around without my controlling it, continued for a couple of hours. Never experienced that before, not sure if related to vaccination or just a random occurrence.

Release 10 — days 1–6 daily, dose 3

2021-10-29

Systemic reaction (other): Last night hands and feet were EXTREMELY cold, rest of my body was too warm. It was odd.

2021-10-30

Systemic reaction (other): Both arm pain and fatigue are much improved, very slight today.

2021-11-02

Systemic reaction (other): Insomnia past two nights, is very unusual but don't know that it's related to vaccination.

Release 11 — 3 months, dose 3

2022-01-26

Symptoms: Mild case of Covid

Release 11 — 6 months, dose 3

2022-04-27

Symptoms: Got extreme arm pain from recent booster - think pharmacist placed injection too high on shoulder.

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	Pain in extremity	·	·	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyskinesia	✓	✓	✓
SRO	Fatigue	·	·	✓
SRO	Headache	✓	✓	✓
SRO	Insomnia	·	·	✓
SRO	Pain in extremity	·	·	✓
SRO	Palpitations	✓	✓	✓
SRO	Peripheral coldness	·	·	✓

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