9HA-14446-41108

4 vaccinations 9 coded responses 31 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 283 / NC
Registered: 2021-03-29

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

N6Q-62425-08574 Child or adolescent in my care · Male · 2022-06-29

L2V-96275-29261 Child or adolescent in my care · Female · 2022-10-13

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-26
Dose 1 — Moderna
2021-03-29
Registered in v-safe
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-01
Survey response — days 1–6 daily, dose 1
MedDRA: Headache, Hypersensitivity, Pre-existing disease — Feeling: Good · Headache

Free text: Seasonal allergies are probably causing headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — day 7, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-04-09
Survey response — day 14, dose 1
MedDRA: Hypersensitivity, Injection site rash, Pre-existing disease, Rash erythematous, Rash pruritic — Feeling: Good

Free text: Shot was 3/26/21 1200. On 4/4/21 developed redness, itchiness, like a rash, in semi-circle shape around shot site. Seasonal allergies worsened 2 days prior, so I suspect my histamines were overactive. Symptoms were gone by 4/7/21.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-23
Dose 2 — Moderna
2021-04-23
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-24
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Swollen lymph nodes in neck, under arm, groin

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-04-30
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-05-07
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-14
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-28
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-23
Survey response — 3 months, dose 2
MedDRA: Hyperemesis gravidarum, Office visit, Pregnancy — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Pregnant, have hyperemesis gravidarum · Healthcare visit (other): Iv fluids 2-3x per week

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-23
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)
2021-07-27
Call 1 — Left Voicemail
2021-10-22
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-03
Dose 3 — Pfizer-BioNTech
2022-04-24
Survey response — 12 months, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-05-04
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-04
Dose 4 — Moderna
2022-10-13
Survey response — day 7, dose 4
MedDRA: Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-10-20
Survey response — day 14, dose 4
MedDRA: Nasopharyngitis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Cold symptoms

MedDRA releases: 2024-11 · check-in free text available
2022-10-25
Survey response — day 21, dose 4
MedDRA: Influenza — Feeling: Fair · Be unable to do your normal daily activities

Free text: Flu

MedDRA releases: 2024-11 · check-in free text available
2022-11-01
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-15
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-01-03
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-04-04
Survey response — 6 months, dose 4
MedDRA: Ear infection — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-26	Moderna
2	2021-04-23	Moderna
3	2021-11-03	Pfizer-BioNTech	No
4	2022-10-04	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-04-01

Systemic reaction (other): Seasonal allergies are probably causing headache

Release 7 — day 14, dose 1

2021-04-09

Symptoms: Shot was 3/26/21 1200. On 4/4/21 developed redness, itchiness, like a rash, in semi-circle shape around shot site. Seasonal allergies worsened 2 days prior, so I suspect my histamines were overactive. Symptoms were gone by 4/7/21.

Release 7 — days 1–6 daily, dose 2

2021-04-24

Systemic reaction (other): Swollen lymph nodes in neck, under arm, groin

Release 9 — 3 months, dose 2

2021-07-23

Symptoms: Pregnant, have hyperemesis gravidarum

Healthcare visit (other): Iv fluids 2-3x per week

Release 11 — 12 months, dose 2

2022-04-24

Symptoms: Sore throat

Release 12 — day 7, dose 4

2022-10-13

Systemic reaction (other): Sore throat

Release 12 — day 14, dose 4

2022-10-20

Symptoms: Cold symptoms

Release 12 — day 21, dose 4

2022-10-25

Symptoms: Flu

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	Office visit	✓	·	✓
SD	Ear infection	·	·	✓
SD	Hyperemesis gravidarum	✓	·	✓
SD	Hypersensitivity	✓	✓	✓
SD	Influenza	·	·	✓
SD	Injection site rash	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pregnancy	✓	·	✓
SD	Rash erythematous	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Pre-existing disease	✓	✓	✓

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