C2F-79218-15553

4 vaccinations 3 coded responses 45 check-ins 3 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 990 / WA
Registered: 2021-02-18

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

Registered dependents

D74-61667-89296 Child or adolescent in my care · Female · 2021-11-08

G4B-10890-36526 Child or adolescent in my care · Male · 2021-11-08

NW7-13426-45168 Child or adolescent in my care · Male · 2021-11-08

DHS-33391-33020 Child or adolescent in my care · Male · 2022-10-15

Timeline

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

2021-02-15
Dose 1 — Moderna
2021-02-18
Registered in v-safe
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-01
Survey response — day 14, dose 1
MedDRA: Immunisation reaction, Injection site erythema, Injection site pruritus, Injection site swelling, Injection site urticaria, Injection site warmth — Feeling: Good

Free text: 2/22 pm hive at injection site, turned itchy, red, swollen and hot. Went away on 2/26. Pretty sure it was covid arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-12
Dose 2 — Moderna
2021-03-12
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Abdominal pain

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Diarrhea, Abdominal pain

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · Headache, Fatigue or tiredness

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-19
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-11
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-10
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-26
Dose 3 — Moderna
2021-11-26
Health check-in — day 0, dose 3
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-11-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Chills, Fatigue or tiredness

Adult check-in
2021-11-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Nausea

Adult check-in
2021-11-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-03
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-10
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-17
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-24
Survey response — day 28, dose 3
MedDRA: Nephrolithiasis, Office visit, Renal stone removal, Surgery — 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, Emergency room or emergency department visit

Free text: Symptoms: Kidney stones and had surgery to remove them yesterday. · Healthcare visit (other): Outpatient surgery

MedDRA releases: 2024-11 · check-in free text available
2021-12-24
Report sent to call center — day 28, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2021-12-27
Call 1 — Left Voicemail
2021-12-31
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-07
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-25
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-27
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-28
Dose 4 — Pfizer-BioNTech
2022-10-05
Survey response — day 7, dose 4
MedDRA: Delivery — Feeling: Good

Free text: Had a baby (b)(6)

MedDRA releases: 2024-11 · check-in free text available
2022-10-12
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-19
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-26
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-02
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-09
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-28
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-29
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-15	Moderna
2	2021-03-12	Moderna
3	2021-11-26	Moderna	No
4	2022-09-28	Pfizer-BioNTech	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 4 — day 14, dose 1

2021-03-01

Symptoms: 2/22 pm hive at injection site, turned itchy, red, swollen and hot. Went away on 2/26. Pretty sure it was covid arm.

Release 10 — day 28, dose 3

2021-12-24

Symptoms: Kidney stones and had surgery to remove them yesterday.

Healthcare visit (other): Outpatient surgery

Release 12 — day 7, dose 4

2022-10-05

Systemic reaction (other): Had a baby (b)(6)

redacted (b)(6)

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	·	·	✓
HCVO	Surgery	·	·	✓
SD	Immunisation reaction	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Injection site urticaria	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Nephrolithiasis	·	·	✓
SD	Renal stone removal	·	·	✓
SRO	Delivery	·	·	✓

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