5F5-19539-97506

4 vaccinations 10 coded responses 34 check-ins 10 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 586 / ND
Registered: 2021-01-05

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

Timeline

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

2021-01-05
Registered in v-safe
2021-01-05
Dose 1 — Moderna
2021-01-05
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-06
Survey response — days 1–6 daily, dose 1
MedDRA: Nasal congestion, Sneezing — Feeling: Good · Site: Pain

Free text: Nasal congestion and lots of sneezing started last evening. I'm not sure if it's vaccine or seasonal/food allergy related

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Survey response — days 1–6 daily, dose 1
MedDRA: Nasal congestion, Sneezing — Feeling: Good · Site: Pain

Free text: Nasal congestion and sneezing are significantly decreased today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-01-12
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Survey response — day 14, dose 1
MedDRA: Erythema, Injection site nodule, Nodule, Pruritus, Skin warm, Urticaria — Feeling: Good

Free text: On day nine I had a track of nodules under my skin starting at injection site and running down my arm about 3-4 inches. They were pea sized initially and by the d d of day one was size of ping pong ball. Red. Hot. Itchy. Some hives too. 2 days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-02
Dose 2 — Moderna
2021-02-02
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Headache — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Dizzy. Unrelenting headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site

Free text: Arm pit tenderness and swelling in the injection arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain — Feeling: Good · Site: Pain, Redness, Swelling · Fever · Headache, Fatigue or tiredness

Free text: Sore armpit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness, Abdominal pain

Free text: Sore armpit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · Headache

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Headache

Adult check-in
2021-02-09
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-04
Survey response — 3 months, dose 2
MedDRA: Bronchitis, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: I had bronchitis · Healthcare visit (other): Clinic visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-03
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-05
Dose 3 — Moderna
2022-02-03
Survey response — 12 months, dose 2
MedDRA: Bronchitis, Cough, Headache, Musculoskeletal stiffness, Pain — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Bronchitis for 8 weeks. Lingering cough. Occasional Headache and stiff neck, body aches

MedDRA releases: 2024-11 · check-in free text available
2022-02-03
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-07
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-09-15
Dose 4 — Pfizer-BioNTech
2022-09-24
Survey response — day 7, dose 4
MedDRA: Axillary pain, Breast pain, Chills, Migraine, Mobility decreased, Pain, Pyrexia — Feeling: Good

Free text: About 16 hrs after dhot I had 101.7 temp, migraine, chills, body aches. For 12 hrs. Arm pit and breast sore for 3 days. With the 3rd dhot I was in bed and fever etc for 2 days

MedDRA releases: 2024-11 · check-in free text available
2022-09-29
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-06
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-13
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-20
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-10-27
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-15
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-16
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-05	Moderna
2	2021-02-02	Moderna
3	2021-11-05	Moderna	No
4	2022-09-15	Pfizer-BioNTech	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-06

Systemic reaction (other): Nasal congestion and lots of sneezing started last evening. I'm not sure if it's vaccine or seasonal/food allergy related

2021-01-07

Systemic reaction (other): Nasal congestion and sneezing are significantly decreased today

Release 2 — day 14, dose 1

2021-01-19

Symptoms: On day nine I had a track of nodules under my skin starting at injection site and running down my arm about 3-4 inches. They were pea sized initially and by the d d of day one was size of ping pong ball. Red. Hot. Itchy. Some hives too. 2 days

Release 3 — days 1–6 daily, dose 2

2021-02-03

Systemic reaction (other): Dizzy. Unrelenting headache

2021-02-04

Systemic reaction (other): Arm pit tenderness and swelling in the injection arm

2021-02-05

Systemic reaction (other): Sore armpit

2021-02-06

Systemic reaction (other): Sore armpit

Release 8 — 3 months, dose 2

2021-05-04

Symptoms: I had bronchitis

Healthcare visit (other): Clinic visit

Release 11 — 12 months, dose 2

2022-02-03

Symptoms: Bronchitis for 8 weeks. Lingering cough. Occasional Headache and stiff neck, body aches

Release 12 — day 7, dose 4

2022-09-24

Systemic reaction (other): About 16 hrs after dhot I had 101.7 temp, migraine, chills, body aches. For 12 hrs. Arm pit and breast sore for 3 days. With the 3rd dhot I was in bed and fever etc for 2 days

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	Bronchitis	✓	✓	✓
SD	Cough	·	·	✓
SD	Erythema	✓	✓	✓
SD	Headache	·	·	✓
SD	Injection site nodule	✓	✓	✓
SD	Musculoskeletal stiffness	·	·	✓
SD	Nodule	✓	✓	✓
SD	Pain	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Skin warm	✓	✓	✓
SD	Urticaria	✓	✓	✓
SRO	Axillary pain	✓	✓	✓
SRO	Breast pain	·	·	✓
SRO	Chills	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Migraine	·	·	✓
SRO	Mobility decreased	·	·	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Pain	·	·	✓
SRO	Pyrexia	·	·	✓
SRO	Sneezing	✓	✓	✓

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