6HM-11586-85722

2 vaccinations 8 coded responses 18 check-ins 8 free-text entries 0 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 923 / CA
Registered: 2021-03-18

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

2021-03-18
Registered in v-safe
2021-03-18
Dose 1 — Moderna
2021-03-18
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy — Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Swollen lymph nodes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Lymphadenopathy, Parosmia — Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Swollen lymph nodes Extreme fatigue-almost as if I have not slept rash down my left trunk/hip, but not on my left arm, where I got vaccine Everything smells like bleach or cooking pinto beans

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — day 7, dose 1
MedDRA: Headache — Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I slept 18 hours straight to get rid of the headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-08
Survey response — day 21, dose 1
MedDRA: Cough, Lymphadenopathy, Oropharyngeal pain, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: I have a sore throat, dry cough, fever & swollen lymph nodes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — day 28, dose 1
MedDRA: Cough, Fatigue, Nasopharyngitis, Oropharyngeal pain, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: I have a bad cold with cough, fever, fatigue & sore throat.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Dose 2 — Moderna
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Urticaria — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Hives

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: Gingival swelling, Toothache, Urticaria — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Hives, gum swelling & teeth hurt

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: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-26
Health check-in — day 7, dose 2
Feeling: Good · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

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: Pancreatitis — Feeling: Poor · Be unable to do your normal daily activities

Free text: I have pancreatitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-18	Moderna
2	2021-04-19	Moderna

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-23

Systemic reaction (other): Swollen lymph nodes

2021-03-24

Systemic reaction (other): Swollen lymph nodes Extreme fatigue-almost as if I have not slept rash down my left trunk/hip, but not on my left arm, where I got vaccine Everything smells like bleach or cooking pinto beans

Release 6 — day 7, dose 1

2021-03-25

Systemic reaction (other): I slept 18 hours straight to get rid of the headache

Release 7 — day 21, dose 1

2021-04-08

Symptoms: I have a sore throat, dry cough, fever & swollen lymph nodes.

Release 7 — day 28, dose 1

2021-04-15

Symptoms: I have a bad cold with cough, fever, fatigue & sore throat.

Release 7 — days 1–6 daily, dose 2

2021-04-22

Systemic reaction (other): Hives

2021-04-23

Systemic reaction (other): Hives, gum swelling & teeth hurt

Release 8 — day 21, dose 2

2021-05-10

Symptoms: I have pancreatitis

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	Cough	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pancreatitis	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Gingival swelling	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Parosmia	✓	✓	✓
SRO	Toothache	✓	✓	✓
SRO	Urticaria	✓	✓	✓

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