AUL-47417-76861

4 vaccinations 3 coded responses 43 check-ins 3 free-text entries 1 call case

Sex: Female
Age at first dose: 46-50
ZIP prefix: 851 / AZ
Registered: 2021-03-04

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

Timeline

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

2021-02-23
Dose 1 — Moderna
2021-03-04
Registered in v-safe
2021-03-04
Survey response — day 7, dose 1
MedDRA: Rash pruritic — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Free text: the itchy rash is about 3 cm from injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-23
Dose 2 — Moderna
2021-03-23
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-29
Survey response — days 1–6 daily, dose 2
MedDRA: Menstrual disorder — Feeling: Good · Site: Pain, Itching · Headache

Free text: Started Menstrual cycle early

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · Headache

Adult check-in
2021-04-06
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-14
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-22
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-21
Survey response — 6 months, dose 2
MedDRA: Atrial fibrillation, Hospitalisation, Immunisation reaction, Rash, Skin hyperpigmentation — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: I was hospitalized for five days with a fib I did not have a fib prior to receiving the vaccine. I also have developed some sort of hyper pigmentation on my arm I received the vaccine and from the covid arm rash

MedDRA releases: 2024-11 · check-in free text available
2021-09-21
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-09-23
Call 1 — Left Voicemail
2021-12-05
Dose 3 — Pfizer-BioNTech
2021-12-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-12-09
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-12-10
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Itching · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-12-11
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-12-12
Health check-in — day 7, dose 3
Feeling: Fair · Site: Pain, Itching · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

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

Adult check-in
2021-12-26
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-02
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-09
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-16
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-06
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-15
Dose 4 — Pfizer-BioNTech
2022-05-15
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-17
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-05-18
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-05-20
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Itching · Fever · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-21
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Itching · Fever · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2022-05-22
Health check-in — day 7, dose 4
Feeling: Fair · Site: Pain, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-29
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-06-05
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-06-12
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-19
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-26
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-14
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-13
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-05-15
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-23	Moderna
2	2021-03-23	Moderna
3	2021-12-05	Pfizer-BioNTech	No
4	2022-05-15	Pfizer-BioNTech	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 5 — day 7, dose 1

2021-03-04

Systemic reaction (other): the itchy rash is about 3 cm from injection site

Release 6 — days 1–6 daily, dose 2

2021-03-29

Systemic reaction (other): Started Menstrual cycle early

Release 9 — 6 months, dose 2

2021-09-21

Symptoms: I was hospitalized for five days with a fib I did not have a fib prior to receiving the vaccine. I also have developed some sort of hyper pigmentation on my arm I received the vaccine and from the covid arm rash

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	Atrial fibrillation	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Immunisation reaction	·	·	✓
SD	Rash	·	·	✓
SD	Skin hyperpigmentation	·	·	✓
SRO	Menstrual disorder	✓	✓	✓
SRO	Rash pruritic	✓	✓	✓

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