5X5-12874-86172

5 vaccinations 19 coded responses 62 check-ins 18 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 853 / AZ
Registered: 2021-02-05

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

2021-02-05
Registered in v-safe
2021-02-05
Dose 1 — Moderna
2021-02-05
Survey response — day 0, dose 1
MedDRA: Dizziness, Injection site warmth, Memory impairment — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Free text: Heat at injection site; dizziness; memory issues

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-10
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia oral — Feeling: Good · Headache, Joint pains

Free text: I had a sudden numbness in my lips and tongue - like Id gone to the dentist and had a shot of Novocain! It was bad for about an hour or so, then got better. Still not feeling 100% normal though.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia oral — Feeling: Good

Free text: Still having slight numbness in my lips

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Survey response — day 14, dose 1
MedDRA: Migraine, Rash — Feeling: Fair

Free text: I have a slight rash on my upper back and shoulders. Also developed a migraine today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Survey response — day 21, dose 1
MedDRA: Chest pain — Feeling: Good

Free text: Some sharp chest pains sort of out of the blue and lasted approximately 20 min one day and other more mild chest pains lasting only a couple of minutes on three other occasions.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Dose 2 — Moderna
2021-03-05
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle spasms — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Muscle spasm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness, Nausea

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good · Site: Pain · Fatigue or tiredness, Nausea

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — day 7, dose 2
Feeling: Poor · Headache, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-26
Survey response — day 21, dose 2
MedDRA: Fatigue, Headache, Nausea — Feeling: Poor

Free text: Headache, nausea, fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — day 28, dose 2
MedDRA: Arthralgia, Myalgia — Feeling: Poor

Free text: Muscle and joint pain has flared up out of the blue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-06
Survey response — 3 months, dose 2
MedDRA: Office visit, Ultrasound scan, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: (Possible) veinous insufficiency in my legs. · Healthcare visit (other): Dr. Office visit and ultrasound

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-06
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-05
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-05
Call 1 — Left Voicemail
2021-11-23
Dose 3 — Moderna
2021-11-24
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-11-26
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-11-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-11-30
Health check-in — day 7, dose 3
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-07
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-21
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-28
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-04
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-24
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-09
Dose 4 — Moderna
2022-04-10
Survey response — days 1–6 daily, dose 4
MedDRA: Lacrimation increased — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Watery eyes

MedDRA releases: 2024-11 · check-in free text available
2022-04-11
Survey response — days 1–6 daily, dose 4
MedDRA: Axillary pain, Lymph node pain, Lymphadenopathy, Pruritus — Feeling: Fair · Site: Pain, Swelling, Itching · Fever

Free text: The swelling and itching isn't really at the injection site, but in the lymph node area of my armpit on the same arm as the injection. The pain is both at the site and the lymph node area.

MedDRA releases: 2024-11 · check-in free text available
2022-04-12
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Free text: Still have swelling in the lymph node under my arm that I received the shot in. Although today is better than it's been.

MedDRA releases: 2024-11 · check-in free text available
2022-04-13
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache

Adult check-in
2022-04-16
Health check-in — day 7, dose 4
Feeling: Good · Headache

Adult check-in
2022-04-23
Survey response — day 14, dose 4
MedDRA: Headache, Malaise, Nasal congestion, Nasopharyngitis, Sneezing — Feeling: Fair

Free text: Feeling like I'm coming down with a cold or something; no energy, sneezing, headache stuffy nose - just basically blah

MedDRA releases: 2024-11 · check-in free text available
2022-04-30
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-05-07
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-05-14
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-05-21
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-07-09
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-08
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in
2022-10-29
Dose 5 — Moderna
2022-10-30
Survey response — days 1–6 daily, dose 5
MedDRA: Decreased appetite — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: No appetite

MedDRA releases: 2024-11 · check-in free text available
2022-10-31
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Nausea

Adult check-in
2022-11-01
Survey response — days 1–6 daily, dose 5
MedDRA: Nasal congestion, Rhinorrhoea — Feeling: Fair · Site: Pain, Itching · Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea

Free text: Stuffy/runny nose

MedDRA releases: 2024-11 · check-in free text available
2022-11-02
Survey response — days 1–6 daily, dose 5
MedDRA: Rhinorrhoea — Feeling: Fair · Site: Pain, Redness · Fatigue or tiredness, Nausea, Diarrhea

Free text: Runny nose

MedDRA releases: 2024-11 · check-in free text available
2022-11-03
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2022-11-04
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-11-05
Health check-in — day 7, dose 5
Feeling: Poor · Headache, Fatigue or tiredness, Nausea

Adult check-in
2022-11-12
Health check-in — day 14, dose 5
Feeling: Fair

Adult check-in
2022-11-19
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-28
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-12-03
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-12-10
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-30
Survey response — 3 months, dose 5
MedDRA: Dizziness, Gastroenteritis viral, Headache — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-04-29
Health check-in — 6 months, dose 5
Feeling: Poor

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-05	Moderna
2	2021-03-05	Moderna
3	2021-11-23	Moderna	No
4	2022-04-09	Moderna	No
5	2022-10-29	Moderna	No

Call center

1 call center case

1 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 3 — day 0, dose 1

2021-02-05

Systemic reaction (other): Heat at injection site; dizziness; memory issues

Release 4 — days 1–6 daily, dose 1

2021-02-10

Systemic reaction (other): I had a sudden numbness in my lips and tongue - like Id gone to the dentist and had a shot of Novocain! It was bad for about an hour or so, then got better. Still not feeling 100% normal though.

2021-02-11

Systemic reaction (other): Still having slight numbness in my lips

Release 4 — day 14, dose 1

2021-02-19

Symptoms: I have a slight rash on my upper back and shoulders. Also developed a migraine today.

Release 4 — day 21, dose 1

2021-02-26

Symptoms: Some sharp chest pains sort of out of the blue and lasted approximately 20 min one day and other more mild chest pains lasting only a couple of minutes on three other occasions.

Release 5 — days 1–6 daily, dose 2

2021-03-06

Systemic reaction (other): Muscle spasm

2021-03-07

Systemic reaction (other): Dizziness

2021-03-08

Systemic reaction (other): Dizziness

Release 6 — day 21, dose 2

2021-03-26

Symptoms: Headache, nausea, fatigue

Release 6 — day 28, dose 2

2021-04-02

Symptoms: Muscle and joint pain has flared up out of the blue

Release 8 — 3 months, dose 2

2021-06-06

Symptoms: (Possible) veinous insufficiency in my legs.

Healthcare visit (other): Dr. Office visit and ultrasound

Release 11 — days 1–6 daily, dose 4

2022-04-10

Systemic reaction (other): Watery eyes

2022-04-11

Systemic reaction (other): The swelling and itching isn't really at the injection site, but in the lymph node area of my armpit on the same arm as the injection. The pain is both at the site and the lymph node area.

2022-04-12

Systemic reaction (other): Still have swelling in the lymph node under my arm that I received the shot in. Although today is better than it's been.

Release 11 — day 14, dose 4

2022-04-23

Symptoms: Feeling like I'm coming down with a cold or something; no energy, sneezing, headache stuffy nose - just basically blah

Release 12 — days 1–6 daily, dose 5

2022-10-30

Systemic reaction (other): No appetite

2022-11-01

Systemic reaction (other): Stuffy/runny nose

2022-11-02

Systemic reaction (other): Runny nose

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	Office visit	✓	✓	✓
HCVO	Ultrasound scan	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Gastroenteritis viral	·	·	✓
SD	Headache	✓	✓	✓
SD	Malaise	·	·	✓
SD	Migraine	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Nasal congestion	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Nausea	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Sneezing	·	·	✓
SD	Unevaluable event	✓	✓	✓
SRO	Axillary pain	·	·	✓
SRO	Decreased appetite	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Hypoaesthesia oral	✓	✓	✓
SRO	Injection site warmth	✓	✓	✓
SRO	Lacrimation increased	·	·	✓
SRO	Lymph node pain	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Memory impairment	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Nasal congestion	·	·	✓
SRO	Pruritus	·	·	✓
SRO	Rhinorrhoea	·	·	✓

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