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5TM-30189-32922

4 vaccinations 11 coded responses 46 check-ins 11 free-text entries 1 call case
Sex
Female
Age at first dose
66+
ZIP prefix
341 / FL
Registered
2021-01-13
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-13
    Registered in v-safe
  2. 2021-01-13
    Dose 1 — Moderna
  3. 2021-01-13
    Survey response — day 0, dose 1
    MedDRA: Injection site pain — Feeling: Good
    Free text: Sore at injection site. Like flu shot.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-01-14
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pain — Feeling: Good · Site: Redness · Abdominal pain
    Free text: Slight and pain, cause be from exciting medical condition
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-01-15
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Redness, Itching · Nausea
    Adult check-in
  6. 2021-01-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-01-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Itching · Fatigue or tiredness
    Adult check-in
  8. 2021-01-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-01-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-01-20
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  11. 2021-01-27
    Survey response — day 14, dose 1
    MedDRA: Injection site discolouration, Injection site erythema, Injection site pain, Injection site rash, Limb discomfort — Feeling: Fair
    Free text: Developed a 3 inches in diameter red ness at injection site. Soreness at this area. Lasted 2 days, area then became blotchy. Site still has discoloration but not as dark. Arm still tender.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-02-03
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-02-09
    Dose 2 — Moderna
  14. 2021-02-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities
    Adult check-in
  15. 2021-02-11
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Muscle or body aches
    Adult check-in
  16. 2021-02-12
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-02-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Itching · Fatigue or tiredness
    Adult check-in
  18. 2021-02-14
    Survey response — days 1–6 daily, dose 2
    MedDRA: Dizziness, Pruritus — Feeling: Good · Headache
    Free text: Body itching and dizziness
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  19. 2021-02-15
    Survey response — days 1–6 daily, dose 2
    MedDRA: Dizziness — Feeling: Good · Fever · Abdominal pain
    Free text: Dizzy
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-02-16
    Health check-in — day 7, dose 2
    Feeling: Good · Headache
    Adult check-in
  21. 2021-02-23
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-03-02
    Survey response — day 21, dose 2
    MedDRA: Headache, Syncope — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free text: Headache, Syncope after giving blood donation
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  23. 2021-03-02
    Report sent to call center — day 21, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  24. 2021-03-09
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-03-16
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-03-23
    Survey response — day 42, dose 2
    MedDRA: Injection site pain — Feeling: Fair
    Free text: Injection site sore
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  27. 2021-05-11
    Survey response — 3 months, dose 2
    MedDRA: Injection site pain — Feeling: Good
    Free text: Injection site arm still sore
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  28. 2021-08-10
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  29. 2021-09-17
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  30. 2021-10-02
    Dose 3 — Moderna
  31. 2021-10-02
    Health check-in — day 0, dose 3
    Feeling: Fair · Site: Pain · Fatigue or tiredness
    Adult check-in
  32. 2021-10-03
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  33. 2021-10-05
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · Diarrhea
    Adult check-in
  34. 2021-10-06
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  35. 2021-10-07
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  36. 2021-10-08
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  37. 2021-10-09
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  38. 2021-10-16
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  39. 2021-10-23
    Survey response — day 21, dose 3
    MedDRA: Injection site pain — Feeling: Good
    Free text: Arm sore at injection site.
    MedDRA releases: 2024-11 · check-in free text available
  40. 2021-10-30
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  41. 2021-11-06
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  42. 2021-11-13
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  43. 2022-01-01
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  44. 2022-04-02
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  45. 2022-04-29
    Dose 4 — Moderna
  46. 2022-05-18
    Survey response — day 14, dose 4
    MedDRA: Pain, Pyrexia — Feeling: Good · Be unable to do your normal daily activities
    Free text: Had fever and body aches 24 he's after shot.
    MedDRA releases: 2024-11 · check-in free text available
  47. 2022-05-20
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  48. 2022-05-27
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  49. 2022-06-03
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  50. 2022-06-10
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  51. 2022-07-29
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  52. 2022-10-28
    Survey response — 6 months, dose 4
    MedDRA: Ageusia, Anosmia, Pain, Pyrexia, SARS-CoV-2 test positive, Tinnitus — Feeling: Good · Be unable to do your normal daily activities
    Free text: Tinnitus, fever, achy,loss of smell and taste ( after tested positive for covid)
    MedDRA releases: 2024-11 · check-in free text available
  53. 2023-04-29
    Health check-in — 12 months, dose 4
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-13Moderna
22021-02-09Moderna
32021-10-02Moderna No
42022-04-29Moderna No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 1 — day 0, dose 1

2021-01-13

Systemic reaction (other): Sore at injection site. Like flu shot.

Release 1 — days 1–6 daily, dose 1

2021-01-14

Systemic reaction (other): Slight and pain, cause be from exciting medical condition

Release 2 — day 14, dose 1

2021-01-27

Symptoms: Developed a 3 inches in diameter red ness at injection site. Soreness at this area. Lasted 2 days, area then became blotchy. Site still has discoloration but not as dark. Arm still tender.

Release 4 — days 1–6 daily, dose 2

2021-02-14

Systemic reaction (other): Body itching and dizziness

2021-02-15

Systemic reaction (other): Dizzy

Release 4 — day 21, dose 2

2021-03-02

Symptoms: Headache, Syncope after giving blood donation

Release 6 — day 42, dose 2

2021-03-23

Symptoms: Injection site sore

Release 8 — 3 months, dose 2

2021-05-11

Symptoms: Injection site arm still sore

Release 10 — day 21, dose 3

2021-10-23

Symptoms: Arm sore at injection site.

Release 11 — day 14, dose 4

2022-05-18

Symptoms: Had fever and body aches 24 he's after shot.

Release 12 — 6 months, dose 4

2022-10-28

Symptoms: Tinnitus, fever, achy,loss of smell and taste ( after tested positive for covid)

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

FieldPreferred term2021-092023-042024-11
SDAgeusia · · ✓
SDAnosmia · · ✓
SDHeadache ✓ ✓ ✓
SDInjection site discolouration ✓ ✓ ✓
SDInjection site erythema ✓ ✓ ✓
SDInjection site pain ✓ ✓ ✓
SDInjection site rash ✓ ✓ ✓
SDLimb discomfort ✓ ✓ ✓
SDPain · · ✓
SDPyrexia · · ✓
SDSARS-CoV-2 test positive · · ✓
SDSyncope ✓ ✓ ✓
SDTinnitus · · ✓
SRODizziness ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SROPain ✓ ✓ ✓
SROPruritus ✓ ✓ ✓

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

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