5Z6-15789-68579

4 vaccinations 11 coded responses 39 check-ins 11 free-text entries 0 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 068 / CT
Registered: 2021-03-21

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
2021-03-21
Registered in v-safe
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-02
Survey response — day 14, dose 1
MedDRA: Abdominal discomfort, Diarrhoea, Fatigue, Headache, Injection site erythema, Injection site warmth, Insomnia — Feeling: Fair

Free text: Red & hot at site. Headache on and off. Very tired but cant sleep. Upset stomach with diarrhea today. Havent gone anywhere.

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

Adult check-in
2021-04-16
Dose 2 — Moderna
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-18
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle spasms — Feeling: Fair · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Muscle spasms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-23
Health check-in — day 7, dose 2
Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-30
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-07
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-14
Survey response — day 28, dose 2
MedDRA: Fatigue — Feeling: Fair

Free text: Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-23
Survey response — day 35, dose 2
MedDRA: Arthralgia — Feeling: Good

Free text: Joint pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-16
Survey response — 3 months, dose 2
MedDRA: Paraesthesia — Feeling: Good

Free text: Tingling sensation on surface of my skin on face arm and leg.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-15
Survey response — 6 months, dose 2
MedDRA: Fatigue, Sleep disorder — Feeling: Fair

Free text: Issues sleeping and fatigue

MedDRA releases: 2024-11 · check-in free text available
2021-11-12
Dose 3 — Moderna
2021-11-19
Health check-in — day 7, dose 3
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-26
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-17
Survey response — day 35, dose 3
MedDRA: Arthralgia, Headache — Feeling: Fair

Free text: Headache Joint pain

MedDRA releases: 2024-11 · check-in free text available
2021-12-26
Survey response — day 42, dose 3
MedDRA: Erythema, Neuralgia — Feeling: Fair

Free text: Weird sharp quick nerve pain in random places and red knuckles on hands.

MedDRA releases: 2024-11 · check-in free text available
2022-02-11
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-07
Dose 4 — Pfizer-BioNTech
2022-05-13
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-19
Health check-in — day 7, dose 4
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-21
Survey response — day 14, dose 4
MedDRA: Arthralgia, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Joint & muscle pain.

MedDRA releases: 2024-11 · check-in free text available
2022-05-28
Survey response — day 21, dose 4
MedDRA: Arthritis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Joint inflammation.

MedDRA releases: 2024-11 · check-in free text available
2022-06-06
Survey response — day 28, dose 4
MedDRA: Arthralgia, Hypoaesthesia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Joint pain worsening and right arm from elbow down goes numb on and off throughout the day.

MedDRA releases: 2024-11 · check-in free text available
2022-06-11
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-06-20
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-08-06
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-07
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in
2023-05-09
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-19	Moderna
2	2021-04-16	Moderna
3	2021-11-12	Moderna	No
4	2022-05-07	Pfizer-BioNTech	No

Free text

Release 6 — day 14, dose 1

2021-04-02

Symptoms: Red & hot at site. Headache on and off. Very tired but cant sleep. Upset stomach with diarrhea today. Havent gone anywhere.

Release 7 — days 1–6 daily, dose 2

2021-04-18

Systemic reaction (other): Muscle spasms

Release 8 — day 28, dose 2

2021-05-14

Symptoms: Fatigue

Release 8 — day 35, dose 2

2021-05-23

Symptoms: Joint pain

Release 9 — 3 months, dose 2

2021-07-16

Symptoms: Tingling sensation on surface of my skin on face arm and leg.

Release 10 — 6 months, dose 2

2021-10-15

Symptoms: Issues sleeping and fatigue

Release 10 — day 35, dose 3

2021-12-17

Symptoms: Headache Joint pain

Release 10 — day 42, dose 3

2021-12-26

Symptoms: Weird sharp quick nerve pain in random places and red knuckles on hands.

Release 11 — day 14, dose 4

2022-05-21

Symptoms: Joint & muscle pain.

Release 11 — day 21, dose 4

2022-05-28

Symptoms: Joint inflammation.

Release 11 — day 28, dose 4

2022-06-06

Symptoms: Joint pain worsening and right arm from elbow down goes numb on and off throughout the 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	Abdominal discomfort	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Arthritis	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Erythema	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypoaesthesia	·	·	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Myalgia	·	·	✓
SD	Neuralgia	·	·	✓
SD	Paraesthesia	✓	·	✓
SD	Sleep disorder	·	·	✓
SRO	Muscle spasms	✓	✓	✓

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