6TR-92587-10692

5 vaccinations 12 coded responses 57 check-ins 12 free-text entries 0 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 100 / NY
Registered: 2021-01-19

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

2021-01-19
Registered in v-safe
2021-01-19
Dose 1 — Moderna
2021-01-19
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-01-20
Survey response — days 1–6 daily, dose 1
MedDRA: Muscle spasms — Feeling: Fair · Site: Pain, Swelling · Fever · Muscle or body aches, Fatigue or tiredness

Free text: Muscle spasm in neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-26
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-02
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-09
Survey response — day 21, dose 1
MedDRA: Headache — Feeling: Good

Free text: Frequent Headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-17
Dose 2 — Moderna
2021-02-17
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-20
Survey response — days 1–6 daily, dose 2
MedDRA: Urinary tract infection — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to work

Free text: UTI like symptoms which are very unusual for me

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Survey response — days 1–6 daily, dose 2
MedDRA: Urinary tract infection — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness · Be unable to work

Free text: UTI like symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Survey response — days 1–6 daily, dose 2
MedDRA: Inflammation, Urinary tract infection — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Free text: UTI inflammation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Urinary tract infection — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Free text: UTI inflammation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-03
Survey response — day 14, dose 2
MedDRA: Rash erythematous, Rash pruritic — Feeling: Fair

Free text: A raised red and very itchy rash on my vaccine arm. Near the vaccine site on my upper arm. About 3 inches by 4 inches in size. Appeared 8 days after the vaccine. I have a photo if you'd want to see. The rash improved now but still itchy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-26
Survey response — day 35, dose 2
MedDRA: Headache — Feeling: Fair

Free text: Headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-18
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-08
Dose 3 — Pfizer-BioNTech
2021-10-26
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-08
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-09
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-04-01
Dose 4 — Pfizer-BioNTech
2022-04-01
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness

Adult check-in
2022-04-02
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-04-03
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-04-04
Survey response — days 1–6 daily, dose 4
MedDRA: Lip blister, Lip pain — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness

Free text: Blisters on my lips. Started yesterday. Not very painful but tender.

MedDRA releases: 2024-11 · check-in free text available
2022-04-05
Survey response — days 1–6 daily, dose 4
MedDRA: Lip blister — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Blister on lips. Improved some since yesterday.

MedDRA releases: 2024-11 · check-in free text available
2022-04-06
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache

Adult check-in
2022-04-07
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Nausea, Abdominal pain

Adult check-in
2022-04-08
Health check-in — day 7, dose 4
Feeling: Good · Headache

Adult check-in
2022-04-15
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-22
Survey response — day 21, dose 4
MedDRA: Anosmia, Chills, Fatigue, Headache, Pyrexia, Rhinorrhoea — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Four days and counting of 100.5 and up fever, chills, runny nose, headache, loss of smell, fatigue. PCR from 3 days ago negative. Home Antigen tests negative. No known exposure to covid. Vaccinated for flu.

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-06
Survey response — day 35, dose 4
MedDRA: Fatigue — Feeling: Fair

Free text: Fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-05-13
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-01
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-09-23
Dose 5 — Pfizer-BioNTech
2022-09-24
Health check-in — days 1–6 daily, dose 5
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-09-25
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2022-09-26
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2022-09-27
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-09-28
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-09-29
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-09-30
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-10-07
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-14
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-21
Health check-in — day 28, dose 5
Feeling: Fair

Adult check-in
2022-10-28
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-04
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-23
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-26
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-19	Moderna
2	2021-02-17	Moderna
3	2021-09-08	Pfizer-BioNTech	No
4	2022-04-01	Pfizer-BioNTech	No
5	2022-09-23	Pfizer-BioNTech	No

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-20

Systemic reaction (other): Muscle spasm in neck

Release 3 — day 21, dose 1

2021-02-09

Symptoms: Frequent Headaches

Release 4 — days 1–6 daily, dose 2

2021-02-20

Systemic reaction (other): UTI like symptoms which are very unusual for me

2021-02-21

Systemic reaction (other): UTI like symptoms

2021-02-22

Systemic reaction (other): UTI inflammation

2021-02-23

Systemic reaction (other): UTI inflammation

Release 5 — day 14, dose 2

2021-03-03

Symptoms: A raised red and very itchy rash on my vaccine arm. Near the vaccine site on my upper arm. About 3 inches by 4 inches in size. Appeared 8 days after the vaccine. I have a photo if you'd want to see. The rash improved now but still itchy.

Release 6 — day 35, dose 2

2021-03-26

Symptoms: Headaches

Release 11 — days 1–6 daily, dose 4

2022-04-04

Systemic reaction (other): Blisters on my lips. Started yesterday. Not very painful but tender.

2022-04-05

Systemic reaction (other): Blister on lips. Improved some since yesterday.

Release 11 — day 21, dose 4

2022-04-22

Symptoms: Four days and counting of 100.5 and up fever, chills, runny nose, headache, loss of smell, fatigue. PCR from 3 days ago negative. Home Antigen tests negative. No known exposure to covid. Vaccinated for flu.

Release 11 — day 35, dose 4

2022-05-06

Symptoms: Fatigue

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	Anosmia	·	·	✓
SD	Chills	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Rash erythematous	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SRO	Inflammation	✓	✓	✓
SRO	Lip blister	·	·	✓
SRO	Lip pain	·	·	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Urinary tract infection	✓	✓	✓

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