5V3-17834-18841

3 vaccinations 9 coded responses 25 check-ins 9 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 787 / TX
Registered: 2021-03-22

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

2021-03-19
Dose 1 — Moderna
2021-03-22
Registered in v-safe
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Rash, not including the immediate area around the injection site

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness, Itching · Rash, not including the immediate area around the injection site

Adult check-in
2021-03-24
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site erythema, Injection site pruritus — Feeling: Good · Site: Redness

Free text: Slight itching at injection now resolving and site is paler shade of red

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — days 1–6 daily, dose 1
MedDRA: Pain of skin, Rash — Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection site

Free text: Scalp sensitivity , rash clearing up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — day 7, dose 1
MedDRA: Rash — Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection site

Free text: Rash clearing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — day 14, dose 1
MedDRA: Immunisation reaction, Injection site erythema, Injection site pruritus — Feeling: Good

Free text: Covid arm....red circular...very slight itching....was bigger and more red several days ago...now less circular and a bit more spread out but still red and readily apparent looking at the injection site.

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

Adult check-in
2021-04-17
Dose 2 — Moderna
2021-04-17
Health check-in — day 0, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache

Adult check-in
2021-04-20
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal discomfort, Chills, Nausea — Feeling: Fair · Site: Pain · Fever · Diarrhea

Free text: No further chills or nausea, G I upset only in the AM

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling cold — Feeling: Good · Fever

Free text: Although i feel cold i have no temp. Body temp now seems a bit lower than before vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-08
Survey response — day 21, dose 2
MedDRA: Breast pain — Feeling: Good

Free text: Right breast pain is mild but continues ... didn't report before but seems to be improving. Thank you!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-17
Survey response — 3 months, dose 2
MedDRA: Dyspnoea, Palpitations — Feeling: Good

Free text: Palpitations, short of breath....but don't feel this is rated to the vaccine.

MedDRA releases: 2024-11 · check-in free text available
2021-10-16
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-19
Dose 3 — Moderna
2021-10-29
Health check-in — day 7, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-11-02
Survey response — day 14, dose 3
MedDRA: Breast pain, Fatigue — Feeling: Fair

Free text: Continuing breast pain and fatigue. Forgot to mention the breast pain last time. Was havi n g fatigue before the booster.

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-10-24
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-19	Moderna
2	2021-04-17	Moderna
3	2021-10-19	Moderna	No

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-24

Systemic reaction (other): Slight itching at injection now resolving and site is paler shade of red

2021-03-25

Systemic reaction (other): Scalp sensitivity , rash clearing up

Release 6 — day 7, dose 1

2021-03-26

Systemic reaction (other): Rash clearing

Release 6 — day 14, dose 1

2021-04-02

Symptoms: Covid arm....red circular...very slight itching....was bigger and more red several days ago...now less circular and a bit more spread out but still red and readily apparent looking at the injection site.

Release 7 — days 1–6 daily, dose 2

2021-04-20

Systemic reaction (other): No further chills or nausea, G I upset only in the AM

2021-04-23

Systemic reaction (other): Although i feel cold i have no temp. Body temp now seems a bit lower than before vaccine.

Release 8 — day 21, dose 2

2021-05-08

Symptoms: Right breast pain is mild but continues ... didn't report before but seems to be improving. Thank you!

Release 9 — 3 months, dose 2

2021-07-17

Symptoms: Palpitations, short of breath....but don't feel this is rated to the vaccine.

Release 10 — day 14, dose 3

2021-11-02

Symptoms: Continuing breast pain and fatigue. Forgot to mention the breast pain last time. Was havi n g fatigue before the booster.

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	Breast pain	✓	✓	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Immunisation reaction	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Palpitations	·	·	✓
SRO	Abdominal discomfort	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Feeling cold	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pain of skin	✓	✓	✓
SRO	Rash	✓	✓	✓

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