CWV-29110-84397

3 vaccinations 6 coded responses 36 check-ins 6 free-text entries 0 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 670 / KS
Registered: 2021-03-16

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

Registered dependents

TT6-39653-03275 Child or adolescent in my care · Male · 2021-11-13

SGA-10178-91569 Child or adolescent in my care · Male · 2021-11-13

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-03-16
Registered in v-safe
2021-03-16
Dose 1 — Moderna
2021-03-16
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness, Diarrhea, Abdominal pain

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Oedema peripheral — Feeling: Fair

Free text: Swollen arm pit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — day 7, dose 1
MedDRA: Axillary pain — Feeling: Good

Free text: Sore armpit area

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-06
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-13
Dose 2 — Moderna
2021-04-13
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-20
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-18
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-12
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-22
Dose 3 — Moderna
2021-11-23
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-24
Survey response — days 1–6 daily, dose 3
MedDRA: Oedema peripheral — Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Swollen armpit

MedDRA releases: 2024-11 · check-in free text available
2021-11-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-11-26
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Oedema peripheral — Feeling: Good

Free text: Still some soreness from swollen arm pit

MedDRA releases: 2024-11 · check-in free text available
2021-11-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Diarrhea

Adult check-in
2021-11-29
Health check-in — day 7, dose 3
Feeling: Fair · Fever · Chills, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-12-06
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-13
Survey response — day 21, dose 3
MedDRA: Fatigue — Feeling: Fair

Free text: Fatigue

MedDRA releases: 2024-11 · check-in free text available
2021-12-20
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-27
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-21
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-23
Survey response — 6 months, dose 3
MedDRA: COVID-19, Oropharyngeal pain, Pregnancy test positive, Respiratory tract congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sore throat and congestion due to covid and positive pregnancy test.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-16	Moderna
2	2021-04-13	Moderna
3	2021-11-22	Moderna	No

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-22

Systemic reaction (other): Swollen arm pit

Release 6 — day 7, dose 1

2021-03-23

Systemic reaction (other): Sore armpit area

Release 10 — days 1–6 daily, dose 3

2021-11-24

Systemic reaction (other): Swollen armpit

2021-11-26

Systemic reaction (other): Still some soreness from swollen arm pit

Release 10 — day 21, dose 3

2021-12-13

Symptoms: Fatigue

Release 11 — 6 months, dose 3

2022-05-23

Symptoms: Sore throat and congestion due to covid and positive pregnancy test.

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	COVID-19	·	·	✓
SD	Fatigue	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pregnancy test positive	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SRO	Axillary pain	✓	✓	✓
SRO	Oedema peripheral	✓	✓	✓

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