5BR-29681-84743

2 vaccinations 9 coded responses 18 check-ins 9 free-text entries 0 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 920 / CA
Registered: 2021-01-14

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

2021-01-14
Registered in v-safe
2021-01-14
Dose 1 — Moderna
2021-01-14
Survey response — day 0, dose 1
MedDRA: Feeling hot, Flushing — Feeling: Good · Site: Pain · Headache

Free text: Face got a little flushed on my way home. Ears felt hot too.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness, Diarrhea, Abdominal pain

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Survey response — days 1–6 daily, dose 1
MedDRA: Chest pain, Pre-existing disease — Feeling: Good · Nausea

Free text: Pain in right/center chest when bending over. Have had mediastinal lymphnode swelling prior to injection so I don't know if related

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-28
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-04
Survey response — day 21, dose 1
MedDRA: Headache, Migraine — Feeling: Fair

Free text: Headache for past 2 days, turned into migraine this morning. Not sure if related.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Dose 2 — Moderna
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia, Injection site pain, Lymph node pain, Pain in extremity, Paraesthesia, Vaccine positive rechallenge — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Left upper pain under collar bone, but above breast. maybe lymph nodes? It Happened with first vaccine also. First time it happened about 40 min after injection, this time it was almost 4-5 hours after lasting until yesterday (2/12/21). Today it is off and on. Pain at injection site and down left arm, like a tingling numb feeling in left forearm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea

Adult check-in
2021-02-16
Survey response — days 1–6 daily, dose 2
MedDRA: Rash, Rash pruritic — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Rash on left side of neck, itchy, same side as injection. Lasted about 30 min.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness, Diarrhea, Abdominal pain

Adult check-in
2021-02-25
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-04
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-11
Survey response — day 28, dose 2
MedDRA: Erythema — Feeling: Fair

Free text: Since my first vaccine I have had a red/raspberry looking spot on my left forearm. I did not have this prior to starting the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — day 35, dose 2
MedDRA: Fatigue, Rash, Rash macular — Feeling: Fair

Free text: Still have raspberry colored rash/spotts on left forearm. Very tired.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — day 42, dose 2
MedDRA: Erythema, Fatigue, Headache, Rash — Feeling: Fair

Free text: Red raspberry patch still on left forearm. Rash now appears on inner elbow in the early morning (don't know if this is related) lingering headaches. Still super tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Survey response — 3 months, dose 2
MedDRA: Injection site rash, Rash, Tremor — Feeling: Good

Free text: Inner elbow rash/spots on arm that I recieved shot in. Also, I am not sure if related, but my left hand trembles and shakes very often. Especially when holding something. (I Don't know if it is related, but thought I'd mention)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-14	Moderna
2	2021-02-11	Moderna

Free text

Release 2 — day 0, dose 1

2021-01-14

Systemic reaction (other): Face got a little flushed on my way home. Ears felt hot too.

Release 2 — days 1–6 daily, dose 1

2021-01-19

Systemic reaction (other): Pain in right/center chest when bending over. Have had mediastinal lymphnode swelling prior to injection so I don't know if related

Release 3 — day 21, dose 1

2021-02-04

Symptoms: Headache for past 2 days, turned into migraine this morning. Not sure if related.

Release 4 — days 1–6 daily, dose 2

2021-02-13

Systemic reaction (other): Left upper pain under collar bone, but above breast. maybe lymph nodes? It Happened with first vaccine also. First time it happened about 40 min after injection, this time it was almost 4-5 hours after lasting until yesterday (2/12/21). Today it is off and on. Pain at injection site and down left arm, like a tingling numb feeling in left forearm.

2021-02-16

Systemic reaction (other): Rash on left side of neck, itchy, same side as injection. Lasted about 30 min.

Release 5 — day 28, dose 2

2021-03-11

Symptoms: Since my first vaccine I have had a red/raspberry looking spot on my left forearm. I did not have this prior to starting the vaccine

Release 5 — day 35, dose 2

2021-03-18

Symptoms: Still have raspberry colored rash/spotts on left forearm. Very tired.

Release 6 — day 42, dose 2

2021-03-27

Symptoms: Red raspberry patch still on left forearm. Rash now appears on inner elbow in the early morning (don't know if this is related) lingering headaches. Still super tired

Release 8 — 3 months, dose 2

2021-05-15

Symptoms: Inner elbow rash/spots on arm that I recieved shot in. Also, I am not sure if related, but my left hand trembles and shakes very often. Especially when holding something. (I Don't know if it is related, but thought I'd mention)

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	Erythema	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Migraine	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash macular	✓	✓	✓
SD	Tremor	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Feeling hot	✓	✓	✓
SRO	Flushing	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash pruritic	✓	✓	✓
SRO	Vaccine positive rechallenge	✓	✓	✓

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