6N9-25504-09797

4 vaccinations 5 coded responses 40 check-ins 5 free-text entries 0 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 021 / MA
Registered: 2021-04-15

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

2021-04-14
Dose 1 — Moderna
2021-04-15
Registered in v-safe
2021-04-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-28
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-12
Dose 2 — Moderna
2021-05-12
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-05-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-05-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-05-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-05-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-19
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-26
Survey response — day 14, dose 2
MedDRA: Rash — Feeling: Good

Free text: A rash suddenly reappeared under both arm pits two weeks after dose two.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-04
Survey response — day 21, dose 2
MedDRA: Rash, Rash papular, Rash pruritic — Feeling: Good

Free text: The rash that appeared post 2nd dose under both armpits is still visible, raised and slightly itchy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Survey response — day 28, dose 2
MedDRA: Diarrhoea, Pain, Rash, Rash pruritic, SARS-CoV-2 test — Feeling: Fair

Free text: Continued Moderna rash that appeared after 2nd dose, under both arm pits. It has increased in size and is more itchy. Body aches and diarrhea. Went and had a COVID test today. Results due back Monday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-11
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-12-03
Dose 3 — Moderna
2021-12-03
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-12-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection site

Adult check-in
2021-12-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-12-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-12-10
Health check-in — day 7, dose 3
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-12-19
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-31
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-07
Survey response — day 35, dose 3
MedDRA: Exposure to SARS-CoV-2, Nasopharyngitis — Feeling: Fair

Free text: Have a cold and was exposed to my daughter who tested positive for COVID

MedDRA releases: 2024-11 · check-in free text available
2022-01-16
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-05
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-26
Dose 4 — Pfizer-BioNTech
2022-06-05
Survey response — 6 months, dose 3
MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school

Free text: COVID +

MedDRA releases: 2024-11 · check-in free text available
2022-06-24
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-07-02
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-09
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-25
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-05-26
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-14	Moderna
2	2021-05-12	Moderna
3	2021-12-03	Moderna	No
4	2022-05-26	Pfizer-BioNTech	No

Free text

Release 8 — day 14, dose 2

2021-05-26

Symptoms: A rash suddenly reappeared under both arm pits two weeks after dose two.

Release 8 — day 21, dose 2

2021-06-04

Symptoms: The rash that appeared post 2nd dose under both armpits is still visible, raised and slightly itchy.

Release 9 — day 28, dose 2

2021-06-10

Symptoms: Continued Moderna rash that appeared after 2nd dose, under both arm pits. It has increased in size and is more itchy. Body aches and diarrhea. Went and had a COVID test today. Results due back Monday.

Release 10 — day 35, dose 3

2022-01-07

Symptoms: Have a cold and was exposed to my daughter who tested positive for COVID

Release 11 — 6 months, dose 3

2022-06-05

Symptoms: COVID +

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	COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pain	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash papular	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SD	SARS-CoV-2 test	✓	✓	✓

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