5HN-33284-57603

3 vaccinations 13 coded responses 23 check-ins 12 free-text entries 0 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 857 / AZ
Registered: 2021-02-05

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-02-05
Registered in v-safe
2021-02-05
Dose 1 — Moderna
2021-02-05
Survey response — day 0, dose 1
MedDRA: Dizziness, Headache — Feeling: Good · Headache

Free text: Headache is mild. Some slight dizziness early in the day. Neither were strong enough that I had to leave work. Headache comes and goes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain, Injection site erythema, Injection site swelling — Feeling: Good · Site: Redness, Swelling · Muscle or body aches

Free text: Large red swollen area around the injection site about 5 x 3. Mild pain in center of back

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — days 1–6 daily, dose 1
MedDRA: Erythema, Skin swelling — Feeling: Good · Site: Redness, Swelling

Free text: Redness and swallow swollen area has increased to about a 4 x 6 area. Perimeter is a darker red than the center which is more pinkish.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Survey response — days 1–6 daily, dose 1
MedDRA: Erythema, Peripheral swelling — Feeling: Good · Site: Redness, Swelling

Free text: Swelling in feet redness continues to spread lengthwise into the sides kind of like a spider bite. No pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing condition improved, Scleroderma, Swelling — Feeling: Good · Site: Redness, Swelling

Free text: Redness receding. Swelling not as bad, but hardening instead of soft. No pain when touched.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — days 1–6 daily, dose 1
MedDRA: Erythema, Swelling — Feeling: Good · Site: Swelling

Free text: Minimal swelling. Redness gone.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-26
Survey response — day 21, dose 1
MedDRA: Pruritus — Feeling: Good

Free text: Strange, mild itching on top of hand and wrist On arm where inoculation was. Probably unrelated.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Dose 2 — Moderna
2021-03-08
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Good

Free text: Slightly light-headed.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Pain in extremity, Peripheral swelling — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: These were yesterday symptoms. It would not let me submit my symptoms yesterday. Today its just the redness and swelling in my arm. Moderate pain in arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain, Pruritus, Swelling — Feeling: Good · Site: Swelling

Free text: Swelling mild, but still some pain if rested. At injection site only. Yesterday and the day before I had itching in lower arm of injected arm, but it would not let me submit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-29
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-12
Survey response — day 35, dose 2
MedDRA: Diarrhoea — Feeling: Good

Free text: Diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Survey response — day 42, dose 2
MedDRA: Abnormal faeces — Feeling: Good

Free text: After bowel movements, theres a unusual residual fluid, reddish brown, that makes it difficult to wipe clean. Not drippy just a small amount. Probably not related to the shot. Thought Id mention it anyway.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-07
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-06
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-04
Dose 3 — Moderna
2022-03-09
Health check-in — 12 months, dose 2
Feeling: Good

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

Adult check-in
2023-01-04
Survey response — 12 months, dose 3
MedDRA: Atrial fibrillation — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-05	Moderna
2	2021-03-08	Moderna
3	2022-01-04	Moderna	No

Free text

Release 3 — day 0, dose 1

2021-02-05

Systemic reaction (other): Headache is mild. Some slight dizziness early in the day. Neither were strong enough that I had to leave work. Headache comes and goes

Release 3 — days 1–6 daily, dose 1

2021-02-06

Systemic reaction (other): Large red swollen area around the injection site about 5 x 3. Mild pain in center of back

2021-02-07

Systemic reaction (other): Redness and swallow swollen area has increased to about a 4 x 6 area. Perimeter is a darker red than the center which is more pinkish.

2021-02-09

Systemic reaction (other): Swelling in feet redness continues to spread lengthwise into the sides kind of like a spider bite. No pain.

Release 4 — days 1–6 daily, dose 1

2021-02-10

Systemic reaction (other): Redness receding. Swelling not as bad, but hardening instead of soft. No pain when touched.

2021-02-11

Systemic reaction (other): Minimal swelling. Redness gone.

Release 4 — day 21, dose 1

2021-02-26

Symptoms: Strange, mild itching on top of hand and wrist On arm where inoculation was. Probably unrelated.

Release 5 — day 0, dose 2

2021-03-08

Systemic reaction (other): Slightly light-headed.

Release 5 — days 1–6 daily, dose 2

2021-03-10

Systemic reaction (other): These were yesterday symptoms. It would not let me submit my symptoms yesterday. Today its just the redness and swelling in my arm. Moderate pain in arm.

2021-03-13

Systemic reaction (other): Swelling mild, but still some pain if rested. At injection site only. Yesterday and the day before I had itching in lower arm of injected arm, but it would not let me submit

Release 7 — day 35, dose 2

2021-04-12

Symptoms: Diarrhea

Release 7 — day 42, dose 2

2021-04-19

Symptoms: After bowel movements, theres a unusual residual fluid, reddish brown, that makes it difficult to wipe clean. Not drippy just a small amount. Probably not related to the shot. Thought Id mention it anyway.

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	Abnormal faeces	✓	✓	✓
SD	Atrial fibrillation	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Pruritus	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Pre-existing condition improved	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Scleroderma	✓	✓	✓
SRO	Skin swelling	✓	✓	✓
SRO	Swelling	✓	✓	✓

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