5M5-22764-61800

3 vaccinations 6 coded responses 21 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 070 / NJ
Registered: 2021-01-12

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

Timeline

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

2021-01-08
Dose 1 — Moderna
2021-01-12
Registered in v-safe
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-17
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-23
Survey response — day 14, dose 1
MedDRA: Blood glucose decreased, Headache, Pre-existing disease, Therapeutic response unexpected — Feeling: Good

Free text: Headache One thing of note, I am diabetic and the vaccine seems to have lowered my blood sugar. I need less insulin.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-05
Dose 2 — Moderna
2021-02-05
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Blood glucose increased, Hypoglycaemia — Feeling: Fair · Site: Pain, Redness, Itching · Chills, Headache · Be unable to do your normal daily activities

Free text: I am diabetic. The first vaccine caused me to have hypoglycemia and the second vaccine caused extremely elevated blood sugar readings. I needed 3-4 times my normal insulin dosage to bring my blood sugar to my target range.

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, Swelling, Itching · Chills, Headache, Joint pains

Adult check-in
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenitis, Rash pruritic — Feeling: Good · Site: Pain, Itching · Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Rash was in the arm pit of the arm where I received the vaccine. Very itchy. Inflamed lymph nodes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Survey response — days 1–6 daily, dose 2
MedDRA: Lymph node pain, Lymphadenopathy, Physiotherapy, Rash — Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Rash under arm. Lymph nodes are blocked. Painful. · Healthcare visit (other): Physical therapist to help unblock lymph nodes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-12
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-02-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-05
Survey response — day 28, dose 2
MedDRA: Medical counselling, Rash — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Rash developed on both legs and nape of neck. · Healthcare visit (other): Phone consult

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-15
Survey response — day 35, dose 2
MedDRA: Headache, Lymphadenopathy, Physiotherapy — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: HeadacheBlocked lymph nodes · Healthcare visit (other): Physical therapist to unblock lymph nodes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-16
Call 1 — Requested Callback
2021-07-28
Call 2 — Left Voicemail
2021-07-28
Callback requested for
05:00PM ET
2021-08-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-09
Dose 3 — Moderna
2021-10-26
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-10
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-08	Moderna
2	2021-02-05	Moderna
3	2021-09-09	Moderna	No

Call center

3 call center cases

3 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 2 — day 14, dose 1

2021-01-23

Symptoms: Headache One thing of note, I am diabetic and the vaccine seems to have lowered my blood sugar. I need less insulin.

Release 3 — days 1–6 daily, dose 2

2021-02-06

Systemic reaction (other): I am diabetic. The first vaccine caused me to have hypoglycemia and the second vaccine caused extremely elevated blood sugar readings. I needed 3-4 times my normal insulin dosage to bring my blood sugar to my target range.

2021-02-08

Systemic reaction (other): Rash was in the arm pit of the arm where I received the vaccine. Very itchy. Inflamed lymph nodes.

2021-02-09

Systemic reaction (other): Rash under arm. Lymph nodes are blocked. Painful.

Healthcare visit (other): Physical therapist to help unblock lymph nodes

Release 5 — day 28, dose 2

2021-03-05

Symptoms: Rash developed on both legs and nape of neck.

Healthcare visit (other): Phone consult

Release 5 — day 35, dose 2

2021-03-15

Symptoms: HeadacheBlocked lymph nodes

Healthcare visit (other): Physical therapist to unblock lymph nodes

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	Lymphadenopathy	✓	✓	✓
HCVO	Medical counselling	✓	✓	✓
HCVO	Physiotherapy	✓	✓	✓
SD	Blood glucose decreased	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Therapeutic response unexpected	✓	✓	✓
SRO	Blood glucose increased	✓	✓	✓
SRO	Hypoglycaemia	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenitis	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash pruritic	✓	✓	✓

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