68J-33525-37690

3 vaccinations 18 coded responses 27 check-ins 18 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 912 / CA
Registered: 2021-02-28

Relationship: Self
Race: Asian
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-02-28
Registered in v-safe
2021-03-01
Dose 1 — Moderna
2021-03-01
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-02
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease, Swollen tongue — Feeling: Good · Site: Pain · Fatigue or tiredness, Nausea

Free text: About after 5 hours of injection, notice very mild swelling on tongue that subside in 2 hours. I have had angioedema from unknown cause for 2 years. The swelling was within the usual range after exercise and being outside in hot weather. No breathing nor swallowing problem.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Swelling face — Feeling: Good · Site: Itching · Nausea

Free text: light headed (mild); face swelling (mild)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Swelling face — Feeling: Good

Free text: face swelling (mild)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — days 1–6 daily, dose 1
MedDRA: Swelling face — Feeling: Good · Headache

Free text: Face swelling (mild)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — days 1–6 daily, dose 1
MedDRA: Swelling face — Feeling: Good

Free text: face swelling (mild)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-08
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-15
Survey response — day 14, dose 1
MedDRA: Erythema, Induration, Injection site reaction, Pruritus, Swelling — Feeling: Good

Free text: New: covid arm, about 4x5 inches, around injected site. Hard swelling, red and itchy. No pain.Started in the 8th day after vaccine(3/8).Swelling, red subsided in about 6 days(3/13).Now (3/15) still have the itch, but less frequent.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-29
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-30
Dose 2 — Moderna
2021-03-30
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: light headed (mild)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — days 1–6 daily, dose 2
MedDRA: Swelling face — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: face swelling (mild)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Swelling face — Feeling: Good · Site: Pain, Redness, Swelling · Fever · Joint pains, Fatigue or tiredness

Free text: face swelling (mild)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Swelling face — Feeling: Good · Site: Redness, Swelling, Itching · Joint pains, Fatigue or tiredness

Free text: face swelling (mild)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Swelling face — Feeling: Good · Site: Redness, Swelling, Itching · Joint pains, Fatigue or tiredness

Free text: face swelling (mild)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-06
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-20
Survey response — day 21, dose 2
MedDRA: Dizziness, Insomnia — Feeling: Good

Free text: light headed (mild)wake up during sleep at night and have difficulty to fall back to sleep (mild)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — day 28, dose 2
MedDRA: Vitamin D decreased — Feeling: Good

Free text: Low vitamin D in blood test

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Survey response — day 35, dose 2
MedDRA: Dizziness, Fatigue, Hot flush, Initial insomnia, Middle insomnia, Palpitations — Feeling: Good

Free text: (1) Palpitations+dizzy+hot flushes happened together, lasted less than 1/2 hour.Not serious.Happened once today 5/4.(2) Feeling tired, but difficult to fall asleep and easily wake up.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Survey response — day 42, dose 2
MedDRA: Blood test, Fatigue, Insomnia, Palpitations — Feeling: Fair

Free text: palpitations, insomnia, fatigue.Blood test TSH slightly lower than reference min.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-01
Survey response — 3 months, dose 2
MedDRA: Angioedema, Blood thyroid stimulating hormone decreased, Postmenopausal haemorrhage, Pre-existing disease, Urticaria — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: low TSH, urticaria, worsen angioedema, slight post menopausal bleeding

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-01
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-08
Call 1 — Left Voicemail
2021-09-28
Survey response — 6 months, dose 2
MedDRA: Disturbance in attention, Fatigue, Headache — Feeling: Fair

Free text: headache, fatigue, difficulty to concentrate

MedDRA releases: 2024-11 · check-in free text available
2022-04-01
Survey response — 12 months, dose 2
MedDRA: Brain fog, Disturbance in attention — Feeling: Good

Free text: difficult to concentrate mild brain fog

MedDRA releases: 2024-11 · check-in free text available
2022-04-08
Dose 3 — Moderna

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-01	Moderna
2	2021-03-30	Moderna
3	2022-04-08	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-03-02

Systemic reaction (other): About after 5 hours of injection, notice very mild swelling on tongue that subside in 2 hours. I have had angioedema from unknown cause for 2 years. The swelling was within the usual range after exercise and being outside in hot weather. No breathing nor swallowing problem.

Release 5 — days 1–6 daily, dose 1

2021-03-03

Systemic reaction (other): light headed (mild); face swelling (mild)

2021-03-04

Systemic reaction (other): face swelling (mild)

2021-03-05

Systemic reaction (other): Face swelling (mild)

2021-03-06

Systemic reaction (other): face swelling (mild)

Release 5 — day 14, dose 1

2021-03-15

Symptoms: New: covid arm, about 4x5 inches, around injected site. Hard swelling, red and itchy. No pain.Started in the 8th day after vaccine(3/8).Swelling, red subsided in about 6 days(3/13).Now (3/15) still have the itch, but less frequent.

Release 6 — day 0, dose 2

2021-03-30

Systemic reaction (other): light headed (mild)

Release 6 — days 1–6 daily, dose 2

2021-03-31

Systemic reaction (other): face swelling (mild)

2021-04-01

Systemic reaction (other): face swelling (mild)

2021-04-02

Systemic reaction (other): face swelling (mild)

2021-04-03

Systemic reaction (other): face swelling (mild)

Release 7 — day 21, dose 2

2021-04-20

Symptoms: light headed (mild)wake up during sleep at night and have difficulty to fall back to sleep (mild)

Release 8 — day 28, dose 2

2021-04-27

Symptoms: Low vitamin D in blood test

Release 8 — day 35, dose 2

2021-05-04

Symptoms: (1) Palpitations+dizzy+hot flushes happened together, lasted less than 1/2 hour.Not serious.Happened once today 5/4.(2) Feeling tired, but difficult to fall asleep and easily wake up.

Release 8 — day 42, dose 2

2021-05-11

Symptoms: palpitations, insomnia, fatigue.Blood test TSH slightly lower than reference min.

Release 9 — 3 months, dose 2

2021-07-01

Symptoms: low TSH, urticaria, worsen angioedema, slight post menopausal bleeding

Release 9 — 6 months, dose 2

2021-09-28

Symptoms: headache, fatigue, difficulty to concentrate

Release 11 — 12 months, dose 2

2022-04-01

Symptoms: difficult to concentrate mild brain fog

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	Angioedema	✓	✓	✓
SD	Blood test	✓	✓	✓
SD	Blood thyroid stimulating hormone decreased	✓	✓	✓
SD	Brain fog	·	·	✓
SD	Disturbance in attention	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Hot flush	✓	✓	✓
SD	Induration	✓	✓	✓
SD	Initial insomnia	✓	✓	✓
SD	Injection site reaction	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Middle insomnia	✓	✓	✓
SD	Palpitations	✓	✓	✓
SD	Postmenopausal haemorrhage	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Swelling	✓	✓	✓
SD	Urticaria	✓	✓	✓
SD	Vitamin D decreased	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Swelling face	✓	✓	✓
SRO	Swollen tongue	✓	✓	✓

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