5KF-90261-58002

4 vaccinations 12 coded responses 35 check-ins 12 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 554 / MN
Registered: 2021-03-11

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

2021-03-11
Registered in v-safe
2021-03-11
Dose 1 — Moderna
2021-03-11
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Good · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Free text: A little dizzy

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: Headache — Feeling: Good · Site: Pain · Headache, Joint pains, Fatigue or tiredness

Free text: Mild headache.

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 · Site: Pain · Headache, Joint pains, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea — Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Very slight breathing constriction. On the verge of wheezinglight tightness when breathing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — days 1–6 daily, dose 1
MedDRA: Bronchial oedema, Fatigue, Pain, Wheezing — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: Pain is much milder today. But I feel wheezy. Like my bronchials are swollen. Very very tired.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary pain, Lymph node pain — Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Sore armpit on injection side still. Lymph node pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-03-18
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-08
Dose 2 — Moderna
2021-04-08
Survey response — day 0, dose 2
MedDRA: Feeling hot — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Free text: Cheeks feel warm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Lymph node pain — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: Pain in lymph nodes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Lymph node pain — Feeling: Good · Site: Pain, Swelling · Headache

Free text: Lymph node pain on injection side

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-15
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-22
Survey response — day 14, dose 2
MedDRA: Respiratory tract congestion — Feeling: Good

Free text: Some minor congestion.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
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
2021-05-13
Survey response — day 35, dose 2
MedDRA: Unevaluable event — Feeling: Good

Free text: Have a cyst on finger. Following up with hand specialist.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-08
Survey response — 3 months, dose 2
MedDRA: Surgery — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Hand surgery

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-08
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-13
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-07
Survey response — 6 months, dose 2
MedDRA: Medical counselling, Pyrexia, SARS-CoV-2 test negative, Urinary tract infection — Feeling: Good · Be unable to work or attend school, 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: Symptoms: 9/8/2021 to 9/20/2021 had very high fever due to UTI and possible kidney infection. Had multiple negative Covid tests. Responded to antibiotics. · Healthcare visit (other): Phone calls from nurse and doctor.

MedDRA releases: 2024-11 · check-in free text available
2021-10-07
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-11
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-18
Dose 3 — Moderna
2022-04-09
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-22
Dose 4 — Moderna
2022-04-30
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-06
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-13
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-22
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-27
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-03
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-22
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-21
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-23
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-11	Moderna
2	2021-04-08	Moderna
3	2021-11-18	Moderna	No
4	2022-04-22	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 5 — day 0, dose 1

2021-03-11

Systemic reaction (other): A little dizzy

Release 5 — days 1–6 daily, dose 1

2021-03-12

Systemic reaction (other): Mild headache.

2021-03-14

Systemic reaction (other): Very slight breathing constriction. On the verge of wheezinglight tightness when breathing.

2021-03-15

Systemic reaction (other): Pain is much milder today. But I feel wheezy. Like my bronchials are swollen. Very very tired.

2021-03-16

Systemic reaction (other): Sore armpit on injection side still. Lymph node pain.

Release 7 — day 0, dose 2

2021-04-08

Systemic reaction (other): Cheeks feel warm

Release 7 — days 1–6 daily, dose 2

2021-04-11

Systemic reaction (other): Pain in lymph nodes

2021-04-12

Systemic reaction (other): Lymph node pain on injection side

Release 7 — day 14, dose 2

2021-04-22

Symptoms: Some minor congestion.

Release 8 — day 35, dose 2

2021-05-13

Symptoms: Have a cyst on finger. Following up with hand specialist.

Release 9 — 3 months, dose 2

2021-07-08

Symptoms: Hand surgery

Release 10 — 6 months, dose 2

2021-10-07

Symptoms: 9/8/2021 to 9/20/2021 had very high fever due to UTI and possible kidney infection. Had multiple negative Covid tests. Responded to antibiotics.

Healthcare visit (other): Phone calls from nurse and doctor.

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	Medical counselling	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Surgery	✓	✓	✓
SD	Unevaluable event	✓	✓	✓
SD	Urinary tract infection	·	·	✓
SRO	Axillary pain	✓	✓	✓
SRO	Bronchial oedema	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling hot	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Wheezing	✓	✓	✓

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