67Z-33882-39078

4 vaccinations 12 coded responses 41 check-ins 11 free-text entries 0 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 582 / ND
Registered: 2021-01-04

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

2020-12-30
Dose 1 — Moderna
2021-01-04
Registered in v-safe
2021-01-06
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-13
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-21
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-27
Dose 2 — Moderna
2021-01-27
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-29
Survey response — days 1–6 daily, dose 2
MedDRA: Blepharospasm — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: Eyes twitchy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-04
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-17
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-10
Survey response — day 42, dose 2
MedDRA: Constipation, Lymph node pain — Feeling: Good · Be unable to do your normal daily activities

Free text: Constipation and lymph node pain but do have a double masectomy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-28
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Dose 3 — Moderna
2021-10-24
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Axilla pain in opposite arm

MedDRA releases: 2024-11 · check-in free text available
2021-10-25
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Injection site reaction — Feeling: Good · Site: Pain, Redness

Free text: Axilla pain on arm at injection site

MedDRA releases: 2024-11 · check-in free text available
2021-10-26
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Oedema peripheral, Pre-existing disease — Feeling: Good · Site: Pain, Redness · Muscle or body aches

Free text: Both axilla sore and swollen. But do have history of breast cancer two times

MedDRA releases: 2024-11 · check-in free text available
2021-10-27
Survey response — days 1–6 daily, dose 3
MedDRA: Tenderness — Feeling: Good · Site: Pain, Redness

Free text: Still tender under arm pits

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-29
Health check-in — day 7, dose 3
Feeling: Fair · Site: Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-06
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-14
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-21
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-03
Survey response — day 42, dose 3
MedDRA: Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Very bad headache for 4 days

MedDRA releases: 2024-11 · check-in free text available
2022-01-21
Survey response — 3 months, dose 3
MedDRA: Back pain, Self-medication — Feeling: Good · Be unable to do your normal daily activities

Free text: Really bad lower back pain. Today is the first day I finally can stand the pain without nSAIDS

MedDRA releases: 2024-11 · check-in free text available
2022-10-10
Dose 4 — Pfizer-BioNTech
2022-10-12
Survey response — days 1–6 daily, dose 4
MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizzy

MedDRA releases: 2024-11 · check-in free text available
2022-10-13
Survey response — days 1–6 daily, dose 4
MedDRA: Parosmia, Respiratory tract congestion — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Burnt smell since yesterday, congestion

MedDRA releases: 2024-11 · check-in free text available
2022-10-14
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fever · Headache, Fatigue or tiredness

Adult check-in
2022-10-15
Survey response — days 1–6 daily, dose 4
MedDRA: Nasal congestion — Feeling: Fair · Fatigue or tiredness

Free text: Stuffy nose

MedDRA releases: 2024-11 · check-in free text available
2022-10-17
Health check-in — day 7, dose 4
Feeling: Good · Headache

Adult check-in
2022-10-24
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-11-02
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-07
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-23
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-01-11
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-04-12
Survey response — 6 months, dose 4
MedDRA: Dizziness, Headache — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-30	Moderna
2	2021-01-27	Moderna
3	2021-10-22	Moderna	No
4	2022-10-10	Pfizer-BioNTech	No

Free text

Release 3 — days 1–6 daily, dose 2

2021-01-29

Systemic reaction (other): Eyes twitchy

Release 5 — day 42, dose 2

2021-03-10

Symptoms: Constipation and lymph node pain but do have a double masectomy

Release 10 — days 1–6 daily, dose 3

2021-10-24

Systemic reaction (other): Axilla pain in opposite arm

2021-10-25

Systemic reaction (other): Axilla pain on arm at injection site

2021-10-26

Systemic reaction (other): Both axilla sore and swollen. But do have history of breast cancer two times

2021-10-27

Systemic reaction (other): Still tender under arm pits

Release 10 — day 42, dose 3

2021-12-03

Symptoms: Very bad headache for 4 days

Release 11 — 3 months, dose 3

2022-01-21

Symptoms: Really bad lower back pain. Today is the first day I finally can stand the pain without nSAIDS

Release 12 — days 1–6 daily, dose 4

2022-10-12

Systemic reaction (other): Dizzy

2022-10-13

Systemic reaction (other): Burnt smell since yesterday, congestion

2022-10-15

Systemic reaction (other): Stuffy 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
SD	Back pain	·	·	✓
SD	Constipation	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Headache	·	·	✓
SD	Lymph node pain	✓	✓	✓
SD	Self-medication	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Blepharospasm	✓	✓	✓
SRO	Dizziness	·	·	✓
SRO	Injection site reaction	·	·	✓
SRO	Nasal congestion	·	·	✓
SRO	Oedema peripheral	·	·	✓
SRO	Parosmia	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	Tenderness	·	·	✓

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