5BE-25943-80667

3 vaccinations 17 coded responses 38 check-ins 17 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 170 / PA
Registered: 2021-04-09

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

Registered dependents

72V-31971-45942 Child or adolescent in my care · Male · 2021-12-18

AHQ-11175-06912 Child or adolescent in my care · Female · 2021-12-18

Timeline

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

2021-04-09
Registered in v-safe
2021-04-09
Dose 1 — Moderna
2021-04-09
Health check-in — day 0, dose 1
Feeling: Good · Headache

Adult check-in
2021-04-10
Survey response — days 1–6 daily, dose 1
MedDRA: Palpitations — Feeling: Good · Site: Pain

Free text: Palpitations

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

Adult check-in
2021-04-12
Survey response — days 1–6 daily, dose 1
MedDRA: Nightmare, Palpitations — Feeling: Fair

Free text: Palpitations and bad dreams

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — days 1–6 daily, dose 1
MedDRA: Palpitations — Feeling: Fair

Free text: Palpitations

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-16
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-07
Dose 2 — Moderna
2021-05-07
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-05-07
Survey response — day 0, dose 2
MedDRA: Palpitations — Feeling: Good

Free text: Palpitations

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Survey response — days 1–6 daily, dose 2
MedDRA: Palpitations — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

Free text: Palpitations

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Survey response — days 1–6 daily, dose 2
MedDRA: Oedema peripheral, Palpitations — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work

Free text: Palpitations, really swollen armpit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Survey response — days 1–6 daily, dose 2
MedDRA: Oedema peripheral — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Armpit swelling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Survey response — days 1–6 daily, dose 2
MedDRA: Oedema peripheral, Palpitations — Feeling: Fair · Site: Swelling · Headache, Fatigue or tiredness, Nausea

Free text: Palpitations and armpit swelling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Survey response — days 1–6 daily, dose 2
MedDRA: Oedema peripheral, Palpitations — Feeling: Fair · Site: Swelling · Headache, Fatigue or tiredness, Nausea

Free text: Palpitations and armpit swelling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Survey response — days 1–6 daily, dose 2
MedDRA: Oedema peripheral — Feeling: Fair · Site: Swelling · Headache

Free text: Armpit swelling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — day 7, dose 2
MedDRA: Oedema peripheral — Feeling: Fair · Site: Swelling · Headache

Free text: Armpit swelling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Health check-in — day 14, dose 2
Feeling: Good

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

Adult check-in
2021-06-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-06
Survey response — 3 months, dose 2
MedDRA: Hemiparesis, Paraesthesia — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Tingling and weakness on left side

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-06
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-05
Survey response — 6 months, dose 2
MedDRA: Peptic ulcer — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Peptic ulcer

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-08
Call 1 — Left Voicemail
2021-11-08
Call 1 — Left Voicemail
2021-12-11
Dose 3 — Moderna
2021-12-12
Survey response — days 1–6 daily, dose 3
MedDRA: Hyperhidrosis, Oedema peripheral, Palpitations — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Palpitations, sweating, swollen armpit

MedDRA releases: 2024-11 · check-in free text available
2021-12-13
Survey response — days 1–6 daily, dose 3
MedDRA: Abdominal pain lower, Chest pain, Lymphadenopathy — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Swollen lymph nodes in armpit, sharp lower abdominal pain, intermittent chest pain

MedDRA releases: 2024-11 · check-in free text available
2021-12-14
Survey response — days 1–6 daily, dose 3
MedDRA: Chest pain, Oedema peripheral, Pain in extremity, Palpitations, Paraesthesia — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Intermittent chest pain, palpitations, swollen armpit, leg tingling and pain

MedDRA releases: 2024-11 · check-in free text available
2021-12-15
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Nausea

Adult check-in
2021-12-16
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache, Joint pains

Adult check-in
2021-12-17
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains

Adult check-in
2021-12-18
Health check-in — day 7, dose 3
Feeling: Good · Site: Swelling · Joint pains

Adult check-in
2021-12-27
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-01
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-17
Survey response — day 35, dose 3
MedDRA: Chest pain, Diarrhoea, Headache, Nasal congestion, Vomiting — Feeling: Poor · Be unable to work or attend school

Free text: Vomiting, diarrhea, headache, stuffy nose, chest pain

MedDRA releases: 2024-11 · check-in free text available
2022-01-22
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-03-12
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-09	Moderna
2	2021-05-07	Moderna
3	2021-12-11	Moderna	No

Call center

2 call center cases

2 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-10

Systemic reaction (other): Palpitations

2021-04-12

Systemic reaction (other): Palpitations and bad dreams

2021-04-13

Systemic reaction (other): Palpitations

Release 8 — day 0, dose 2

2021-05-07

Systemic reaction (other): Palpitations

Release 8 — days 1–6 daily, dose 2

2021-05-08

Systemic reaction (other): Palpitations

2021-05-09

Systemic reaction (other): Palpitations, really swollen armpit

2021-05-10

Systemic reaction (other): Armpit swelling

2021-05-11

Systemic reaction (other): Palpitations and armpit swelling

2021-05-12

Systemic reaction (other): Palpitations and armpit swelling

2021-05-13

Systemic reaction (other): Armpit swelling

Release 8 — day 7, dose 2

2021-05-14

Systemic reaction (other): Armpit swelling

Release 9 — 3 months, dose 2

2021-08-06

Symptoms: Tingling and weakness on left side

Release 10 — 6 months, dose 2

2021-11-05

Symptoms: Peptic ulcer

Release 10 — days 1–6 daily, dose 3

2021-12-12

Systemic reaction (other): Palpitations, sweating, swollen armpit

2021-12-13

Systemic reaction (other): Swollen lymph nodes in armpit, sharp lower abdominal pain, intermittent chest pain

2021-12-14

Systemic reaction (other): Intermittent chest pain, palpitations, swollen armpit, leg tingling and pain

Release 10 — day 35, dose 3

2022-01-17

Symptoms: Vomiting, diarrhea, headache, stuffy nose, chest pain

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	Chest pain	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Headache	·	·	✓
SD	Hemiparesis	✓	·	✓
SD	Nasal congestion	·	·	✓
SD	Paraesthesia	✓	·	✓
SD	Peptic ulcer	·	·	✓
SD	Vomiting	·	·	✓
SRO	Abdominal pain lower	·	·	✓
SRO	Chest pain	·	·	✓
SRO	Hyperhidrosis	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Nightmare	✓	✓	✓
SRO	Oedema peripheral	✓	✓	✓
SRO	Pain in extremity	·	·	✓
SRO	Palpitations	✓	✓	✓
SRO	Paraesthesia	·	·	✓

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