5RL-25349-77077

5 vaccinations 10 coded responses 48 check-ins 9 free-text entries 0 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 958 / CA
Registered: 2021-03-03

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

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

Free text: Tingling in hands, feet and ears.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site bruising — Feeling: Good · Site: Pain

Free text: Small bruise at injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-10
Survey response — day 7, dose 1
MedDRA: Injection site bruising — Feeling: Good

Free text: Bruising at injection site is faded to yellowish.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-31
Dose 2 — Moderna
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema, Injection site pruritus, Injection site swelling — Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection site

Free text: 2" x 2" swollen red patch 1/4" to the right of the injection site. This is same location that was very itchy the previous day.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema — Feeling: Good · Site: Swelling · Rash, not including the immediate area around the injection site

Free text: 2nd day with 2" x 2" raised red patch that is 1/4" to the right of the injection site. The patch is less than on the previous day.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema, Injection site swelling — Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection site

Free text: Day 3 of 2"x2" swollwn red patch 1/4" to the right of injection site. Appears to be fading.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — day 7, dose 2
MedDRA: Eye swelling — Feeling: Good

Free text: Right eye has had substantial swellig that started the day after the injection and has not subsided. Thought it was just from seasonal allwrgies, but left eye not swollen. Eye drops prescribed by optometrist have not helped. Vaccine related?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — day 14, dose 2
Feeling: Good

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

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

Adult check-in
2021-05-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-01
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-12
Dose 3 — Moderna
2022-03-31
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-08-15
Dose 4 — Moderna
2022-08-18
Survey response — days 1–6 daily, dose 4
MedDRA: Erythema, Peripheral swelling, Pruritus — Feeling: Good · Site: Redness, Swelling, Itching · Rash, not including the immediate area around the injection site

Free text: Swollen red itchy patch covers most of upper arm (top).

MedDRA releases: 2024-11 · check-in free text available
2022-08-19
Survey response — days 1–6 daily, dose 4
MedDRA: Erythema, Peripheral swelling — Feeling: Good · Site: Redness, Swelling, Itching

Free text: Entire top of upper arm is red and swollen for the 4th day

MedDRA releases: 2024-11 · check-in free text available
2022-08-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2022-08-22
Health check-in — day 7, dose 4
Feeling: Good · Site: Itching · None

Adult check-in
2022-08-29
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-09-05
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-09-12
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-09-20
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-09-26
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-11-14
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-12-07
Dose 5 — Moderna
2022-12-07
Health check-in — day 0, dose 5
Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Diarrhea, Abdominal pain

Adult check-in
2022-12-09
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2022-12-10
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Swelling, Itching · None

Adult check-in
2022-12-11
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Itching · None

Adult check-in
2022-12-12
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Itching · None

Adult check-in
2022-12-13
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-12-14
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-12-21
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-12-28
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2023-01-04
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2023-01-11
Survey response — day 35, dose 5
MedDRA: Cough, Nasopharyngitis, Paranasal sinus hypersecretion, Respiratory tract congestion — Feeling: Fair

MedDRA releases: 2024-11
2023-01-18
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-03-08
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-06-07
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Moderna
2	2021-03-31	Moderna
3	2021-11-12	Moderna	No
4	2022-08-15	Moderna	No
5	2022-12-07	Moderna	No

Free text

Release 5 — day 0, dose 1

2021-03-03

Systemic reaction (other): Tingling in hands, feet and ears.

Release 5 — days 1–6 daily, dose 1

2021-03-06

Systemic reaction (other): Small bruise at injection site.

Release 5 — day 7, dose 1

2021-03-10

Systemic reaction (other): Bruising at injection site is faded to yellowish.

Release 6 — days 1–6 daily, dose 2

2021-04-03

Systemic reaction (other): 2" x 2" swollen red patch 1/4" to the right of the injection site. This is same location that was very itchy the previous day.

2021-04-04

Systemic reaction (other): 2nd day with 2" x 2" raised red patch that is 1/4" to the right of the injection site. The patch is less than on the previous day.

2021-04-05

Systemic reaction (other): Day 3 of 2"x2" swollwn red patch 1/4" to the right of injection site. Appears to be fading.

Release 7 — day 7, dose 2

2021-04-09

Systemic reaction (other): Right eye has had substantial swellig that started the day after the injection and has not subsided. Thought it was just from seasonal allwrgies, but left eye not swollen. Eye drops prescribed by optometrist have not helped. Vaccine related?

Release 12 — days 1–6 daily, dose 4

2022-08-18

Systemic reaction (other): Swollen red itchy patch covers most of upper arm (top).

2022-08-19

Systemic reaction (other): Entire top of upper arm is red and swollen for the 4th day

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	Cough	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Paranasal sinus hypersecretion	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SRO	Erythema	·	·	✓
SRO	Eye swelling	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Peripheral swelling	·	·	✓
SRO	Pruritus	·	·	✓

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