6YV-12694-30325

5 vaccinations 9 coded responses 30 check-ins 8 free-text entries 0 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 787 / TX
Registered: 2021-04-05

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

2021-03-09
Dose 1 — Moderna
2021-04-05
Registered in v-safe
2021-04-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-06
Dose 2 — Moderna
2021-04-09
Survey response — days 1–6 daily, dose 2
MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: I developed a rash the day after my 2nd dose under my breast on the left side, same side where I got the injection in my arm. I believe the rash was heat related and not necessarily vaccine related, but I did want to report it.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-15
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-11
Survey response — day 35, dose 2
MedDRA: Fatigue, Headache, Seasonal allergy — Feeling: Fair · Be unable to do your normal daily activities

Free text: Probably seasonal allergies, fatigue and headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Survey response — day 42, dose 2
MedDRA: Hypersensitivity, Oral herpes, Pre-existing disease — Feeling: Good

Free text: Probably allergy related, but developed a large fever blister in my right nostril, never had one there before, only very rarely Ive had a fever blister on the outside of my left nostril.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-05
Survey response — 6 months, dose 2
MedDRA: Asthenia, Fatigue, Insomnia — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Have a really hard time sleeping, always tired, low energy.

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
Dose 3 — Moderna
2022-04-06
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-03
Dose 4 — Moderna
2022-05-04
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2022-05-05
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2022-05-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2022-05-07
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2022-05-08
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2022-05-09
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2022-05-10
Health check-in — day 7, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-05-17
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-24
Survey response — day 21, dose 4
MedDRA: Abdominal distension, Abdominal pain upper, Diarrhoea, Exposure to SARS-CoV-2, SARS-CoV-2 test negative, Vomiting — Feeling: Good · Be unable to do your normal daily activities

Free text: Probably unrelated, but had extreme stomach cramps, bloating, forced vomiting, some diarrhea starting on 05/18/22 Also someone I live with tested positive for covid 05/23/22, my tests have been negative so far. They are isolating in a separate apt

MedDRA releases: 2024-11 · check-in free text available
2022-05-31
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-07
Survey response — day 35, dose 4
MedDRA: Fatigue, Headache, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test negative, Sneezing — Feeling: Good

Free text: Yesterday, 06/06/2022, I had a sore throat, headache, runny nose, sneezing, and exhaustion. I took an at home Covid Test and it was negative. I am feeling better today though.

MedDRA releases: 2024-11 · check-in free text available
2022-06-14
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-02
Survey response — 3 months, dose 4
MedDRA: COVID-19, Exposure to SARS-CoV-2, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Went through about a 2 week period where I thought I for sure had COVID-19, but I tested negative every time. So assuming it was just really bad allergies. I had also been exposed to someone with covid but seems I steered clear of it.

MedDRA releases: 2024-11 · check-in free text available
2022-09-10
Dose 5 — Moderna
2022-10-10
Survey response — day 28, dose 5
MedDRA: Arrhythmia, Chest discomfort, Fatigue — Feeling: Good · Be unable to work or attend school

Free text: Not sure if related to vaccine, but I'm always very tired and have a weird sensation in my chest usually going from a sitting to laying down position, like my heart beat gets out of rhythm.

MedDRA releases: 2024-11 · check-in free text available
2022-10-15
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-10-22
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-10
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-11
Survey response — 6 months, dose 5
MedDRA: Fatigue — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-09	Moderna
2	2021-04-06	Moderna
3	2021-11-29	Moderna	No
4	2022-05-03	Moderna	No
5	2022-09-10	Moderna	No

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-09

Systemic reaction (other): I developed a rash the day after my 2nd dose under my breast on the left side, same side where I got the injection in my arm. I believe the rash was heat related and not necessarily vaccine related, but I did want to report it.

Release 8 — day 35, dose 2

2021-05-11

Symptoms: Probably seasonal allergies, fatigue and headache

Release 8 — day 42, dose 2

2021-05-18

Symptoms: Probably allergy related, but developed a large fever blister in my right nostril, never had one there before, only very rarely Ive had a fever blister on the outside of my left nostril.

Release 10 — 6 months, dose 2

2021-10-05

Symptoms: Have a really hard time sleeping, always tired, low energy.

Release 11 — day 21, dose 4

2022-05-24

Symptoms: Probably unrelated, but had extreme stomach cramps, bloating, forced vomiting, some diarrhea starting on 05/18/22 Also someone I live with tested positive for covid 05/23/22, my tests have been negative so far. They are isolating in a separate apt cut off by CDC

Release 11 — day 35, dose 4

2022-06-07

Symptoms: Yesterday, 06/06/2022, I had a sore throat, headache, runny nose, sneezing, and exhaustion. I took an at home Covid Test and it was negative. I am feeling better today though.

Release 12 — 3 months, dose 4

2022-08-02

Symptoms: Went through about a 2 week period where I thought I for sure had COVID-19, but I tested negative every time. So assuming it was just really bad allergies. I had also been exposed to someone with covid but seems I steered clear of it.

Release 12 — day 28, dose 5

2022-10-10

Symptoms: Not sure if related to vaccine, but I'm always very tired and have a weird sensation in my chest usually going from a sitting to laying down position, like my heart beat gets out of rhythm.

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	Abdominal distension	·	·	✓
SD	Abdominal pain upper	·	·	✓
SD	Arrhythmia	·	·	✓
SD	Asthenia	·	·	✓
SD	Chest discomfort	·	·	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypersensitivity	✓	✓	✓
SD	Insomnia	·	·	✓
SD	Oral herpes	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Seasonal allergy	✓	✓	✓
SD	Sneezing	·	·	✓
SD	Vomiting	·	·	✓
SRO	Rash	✓	✓	✓

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