5ZM-28543-79062

3 vaccinations 8 coded responses 32 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 151 / PA
Registered: 2021-03-10

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

2021-03-09
Dose 1 — Moderna
2021-03-10
Registered in v-safe
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Nasopharyngitis, Rhinorrhoea — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Mild runny nose and feeling of fighting off a cold

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: Blood glucose decreased, Dizziness — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: A little dizziness but it could have been related to low blood sugar.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Chills, Fatigue or tiredness

Adult check-in
2021-03-15
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Insomnia — Feeling: Fair · Fatigue or tiredness

Free text: The fatigue is due to too much work and not enough sleep...probably unrelated to the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Survey response — day 14, dose 1
MedDRA: Injection site pruritus, Injection site scab — Feeling: Fair

Free text: I noticed some minor scabbing on the upper arm near the injection site...I'm guessing that I must have scratched it in my sleep...don't remember injuring it but do recall some itching.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-06
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-13
Health check-in — day 35, dose 1
Feeling: Fair

Adult check-in
2021-04-14
Dose 2 — Moderna
2021-04-22
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-28
Health check-in — day 14, dose 2
Feeling: Good

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

Adult check-in
2021-05-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-26
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-14
Survey response — 3 months, dose 2
MedDRA: Influenza like illness, Nasopharyngitis — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Flu-and-cold-like symptoms after traveling by air to Florida for a few weeks and spending time with unvaccinated people in late May.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-14
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)
2021-07-26
Call 1 — Left Voicemail
2021-07-30
Call 2 — Left Voicemail
2021-10-13
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-05
Dose 3 — Moderna
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · Joint pains, Fatigue or tiredness

Adult check-in
2021-11-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-11-11
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-12
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-19
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-10
Survey response — day 35, dose 3
MedDRA: Pain in extremity, Peripheral swelling — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sweooing of right hand ccompanied by pain

MedDRA releases: 2024-11 · check-in free text available
2021-12-17
Survey response — day 42, dose 3
MedDRA: Hospitalisation, Peripheral swelling, Surgery — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Medical emergency involving right hand dwelling...surgery on Wednesday 12/15/2021... just released from hospital testerday. Many withcovid on hospitalfloor with same medical staff in both my room aand theirs...hope I don't catch it...hope the hand i · Healthcare visit (other): Surgery

MedDRA releases: 2024-11 · check-in free text available
2021-12-17
Report sent to call center — day 42, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-12-20
Call 2 — Could Not Reach Participant
2021-12-23
Call 3 — Could Not Reach Participant
2022-02-04
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-06
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-05
Survey response — 12 months, dose 3
MedDRA: Blister, Medical counselling, Porphyria, Pruritus, Skin reaction, Skin weeping — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Skin reaction with itching, blistering, oozing...doctos suspect cutaneous porphyria...possibly chemical. Allergy ruled out.

MedDRA releases: 2024-11 · check-in free text available
2022-11-05
Report sent to call center — 12 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-11-07
Call 3 — Left Voicemail
2022-11-07
Call 1 — Left Voicemail
2022-11-07
Call 1 — Left Voicemail
2022-11-08
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-08
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-08
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-09	Moderna
2	2021-04-14	Moderna
3	2021-11-05	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-10

Systemic reaction (other): Mild runny nose and feeling of fighting off a cold

2021-03-13

Systemic reaction (other): A little dizziness but it could have been related to low blood sugar.

2021-03-15

Systemic reaction (other): The fatigue is due to too much work and not enough sleep...probably unrelated to the vaccine.

Release 6 — day 14, dose 1

2021-03-23

Symptoms: I noticed some minor scabbing on the upper arm near the injection site...I'm guessing that I must have scratched it in my sleep...don't remember injuring it but do recall some itching.

Release 9 — 3 months, dose 2

2021-07-14

Symptoms: Flu-and-cold-like symptoms after traveling by air to Florida for a few weeks and spending time with unvaccinated people in late May.

Release 10 — day 35, dose 3

2021-12-10

Symptoms: Sweooing of right hand ccompanied by pain

Release 10 — day 42, dose 3

2021-12-17

Symptoms: Medical emergency involving right hand dwelling...surgery on Wednesday 12/15/2021... just released from hospital testerday. Many withcovid on hospitalfloor with same medical staff in both my room aand theirs...hope I don't catch it...hope the hand i cut off by CDC

Healthcare visit (other): Surgery

Release 12 — 12 months, dose 3

2022-11-05

Symptoms: Skin reaction with itching, blistering, oozing...doctos suspect cutaneous porphyria...possibly chemical. Allergy ruled out.

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	Surgery	·	·	✓
SD	Blister	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Influenza like illness	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site scab	✓	✓	✓
SD	Medical counselling	·	·	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Pain in extremity	·	·	✓
SD	Peripheral swelling	·	·	✓
SD	Porphyria	·	·	✓
SD	Pruritus	·	·	✓
SD	Skin reaction	·	·	✓
SD	Skin weeping	·	·	✓
SD	Surgery	·	·	✓
SRO	Blood glucose decreased	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Nasopharyngitis	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓

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