6CV-20451-63770

3 vaccinations 13 coded responses 22 check-ins 13 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 900 / CA
Registered: 2021-04-20

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

2021-03-20
Dose 1 — Moderna
2021-04-19
Dose 2 — Moderna
2021-04-20
Registered in v-safe
2021-04-20
Survey response — days 1–6 daily, dose 2
MedDRA: Allodynia, Insomnia, Paraesthesia, Pre-existing disease — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Allodynia. Paresthesia possibly unrelated. Some insomnia. Chills werent as bad as Ive had in the past.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — days 1–6 daily, dose 2
MedDRA: Eczema, Hyperhidrosis, Hypersomnia, Pre-existing disease, Pyrexia — Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Slept from 127am to 339pm, havent gotten out of bed yet but did have some breakfast. Probably slept so late since I had so little sleep the past few days. Night before vaccine I had 4 hr 38 min. Night after vaccine 2 hr 19 min. Nap later that day for 1 hr 3 min. Woke up feeling sweaty. But I had a fever of 100.6 and at 1249am (last time I checked before falling asleep). Assuming fever broke in the night. Temp was 98.1 at 906am and then 97.9 at 321pm. Having some itchiness at my pre-existing eczema flare sights. Probably unrelated to vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Eczema, Injection site pain, Pre-existing disease, Pruritus — Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection site

Free text: Itchiness due to eczema. Probably unrelated to vaccine. Also pain at injection site is just soreness to the touch.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: Eczema, Pre-existing disease, Pruritus — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Itchiness at pre-existing eczema flares. Doubt related?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-27
Health check-in — day 7, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-05-03
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-10
Survey response — day 21, dose 2
MedDRA: Lymphadenopathy, Office visit — Feeling: Good

Free text: Right (opposite side of injection) cervical lymph node enlargement 1cm. Probably unrelated as different side from both injections. Doc ordered (bacterial/strep) throat culture it was negative.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-27
Survey response — day 35, dose 2
MedDRA: Full blood count abnormal, Nephrolithiasis, Pre-existing disease, Urine analysis abnormal — 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, Outpatient clinic or urgent care clinic visit

Free text: Passed a kidney stone. Abnormal CBC and urinalysis. Have had kidney stones before.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-02
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-25
Survey response — 3 months, dose 2
MedDRA: Computerised tomogram abnormal, Hepatic cyst, Initial insomnia, Insomnia, Medical observation, Middle insomnia, Myalgia, Nephrolithiasis, Pain, Pain in extremity, Ultrasound scan abnormal — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: sleep difficulties (waking middle of night and sometimes falling asleep. Possibly due to pain Or restless legs). Muscle and all over pain. Including soles of feet. Recently diagnosed with small liver cyst, two more kidney stones · Healthcare visit (other): CT and ultrasound for kidney stones.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-25
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)
2021-08-02
Call 1 — Left Voicemail
2022-04-23
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in
2022-05-10
Dose 3 — Pfizer-BioNTech
2022-05-11
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain — Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: arm pit pain on both sides. Possible other lymph node pain.

MedDRA releases: 2024-11 · check-in free text available
2022-05-12
Survey response — days 1–6 daily, dose 3
MedDRA: Body temperature increased, Lymph node pain, Oedema peripheral — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Lymph node pain in multiple sites (opposite side of body from shot). Swollen arm pit. Possible increased restless leg syndrome symptoms. No fever but temp at one point 99.3

MedDRA releases: 2024-11 · check-in free text available
2022-05-14
Survey response — days 1–6 daily, dose 3
MedDRA: Insomnia, Rash, Unevaluable event — Feeling: Poor · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Neurological: possibly restless leg syndrome flare, but at times so bad felt almost like akathesia. Lead to insomnia. Flexiril didn't relieve symptoms, had to take Ativan. Rash on arm but not at injection site.

MedDRA releases: 2024-11 · check-in free text available
2022-05-15
Survey response — days 1–6 daily, dose 3
MedDRA: Insomnia, Restless legs syndrome, Self-medication — Feeling: Poor · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Severe restless leg, aleve and flexiril didn't help. Tramadol provided slight relief. Insomnia.

MedDRA releases: 2024-11 · check-in free text available
2022-05-17
Survey response — day 7, dose 3
MedDRA: Insomnia, Pain, Restless legs syndrome — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Insomnia due to pain and restless leg

MedDRA releases: 2024-11 · check-in free text available
2022-05-25
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-06-18
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-06-21
Survey response — day 42, dose 3
MedDRA: Migraine, Myalgia, Pain, Weight increased — Feeling: Fair

Free text: Weight gain. Possible increase in appetite. Migraine today. Body aches/muscle pains.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-20	Moderna
2	2021-04-19	Moderna
3	2022-05-10	Pfizer-BioNTech	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-20

Systemic reaction (other): Allodynia. Paresthesia possibly unrelated. Some insomnia. Chills werent as bad as Ive had in the past.

2021-04-21

Systemic reaction (other): Slept from 127am to 339pm, havent gotten out of bed yet but did have some breakfast. Probably slept so late since I had so little sleep the past few days. Night before vaccine I had 4 hr 38 min. Night after vaccine 2 hr 19 min. Nap later that day for 1 hr 3 min. Woke up feeling sweaty. But I had a fever of 100.6 and at 1249am (last time I checked before falling asleep). Assuming fever broke in the night. Temp was 98.1 at 906am and then 97.9 at 321pm. Having some itchiness at my pre-existing eczema flare sights. Probably unrelated to vaccine.

2021-04-22

Systemic reaction (other): Itchiness due to eczema. Probably unrelated to vaccine. Also pain at injection site is just soreness to the touch.

2021-04-23

Systemic reaction (other): Itchiness at pre-existing eczema flares. Doubt related?

Release 8 — day 21, dose 2

2021-05-10

Symptoms: Right (opposite side of injection) cervical lymph node enlargement 1cm. Probably unrelated as different side from both injections. Doc ordered (bacterial/strep) throat culture it was negative.

Release 8 — day 35, dose 2

2021-05-27

Symptoms: Passed a kidney stone. Abnormal CBC and urinalysis. Have had kidney stones before.

Release 9 — 3 months, dose 2

2021-07-25

Symptoms: sleep difficulties (waking middle of night and sometimes falling asleep. Possibly due to pain Or restless legs). Muscle and all over pain. Including soles of feet. Recently diagnosed with small liver cyst, two more kidney stones

Healthcare visit (other): CT and ultrasound for kidney stones.

Release 11 — days 1–6 daily, dose 3

2022-05-11

Systemic reaction (other): arm pit pain on both sides. Possible other lymph node pain.

2022-05-12

Systemic reaction (other): Lymph node pain in multiple sites (opposite side of body from shot). Swollen arm pit. Possible increased restless leg syndrome symptoms. No fever but temp at one point 99.3

2022-05-14

Systemic reaction (other): Neurological: possibly restless leg syndrome flare, but at times so bad felt almost like akathesia. Lead to insomnia. Flexiril didn't relieve symptoms, had to take Ativan. Rash on arm but not at injection site.

2022-05-15

Systemic reaction (other): Severe restless leg, aleve and flexiril didn't help. Tramadol provided slight relief. Insomnia.

Release 11 — day 7, dose 3

2022-05-17

Systemic reaction (other): Insomnia due to pain and restless leg

Release 12 — day 42, dose 3

2022-06-21

Symptoms: Weight gain. Possible increase in appetite. Migraine today. Body aches/muscle pains.

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	Computerised tomogram abnormal	✓	·	✓
HCVO	Nephrolithiasis	✓	·	✓
HCVO	Ultrasound scan abnormal	✓	·	✓
SD	Full blood count abnormal	✓	✓	✓
SD	Hepatic cyst	✓	·	✓
SD	Initial insomnia	✓	·	✓
SD	Insomnia	✓	·	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Medical observation	✓	·	✓
SD	Middle insomnia	✓	·	✓
SD	Migraine	·	·	✓
SD	Myalgia	✓	·	✓
SD	Nephrolithiasis	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Pain	✓	·	✓
SD	Pain in extremity	✓	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Urine analysis abnormal	✓	✓	✓
SD	Weight increased	·	·	✓
SRO	Allodynia	✓	✓	✓
SRO	Axillary pain	·	·	✓
SRO	Body temperature increased	·	·	✓
SRO	Eczema	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Hypersomnia	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Lymph node pain	·	·	✓
SRO	Oedema peripheral	·	·	✓
SRO	Pain	·	·	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rash	·	·	✓
SRO	Restless legs syndrome	·	·	✓
SRO	Self-medication	·	·	✓
SRO	Unevaluable event	·	·	✓

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