G5T-15342-89014

3 vaccinations 13 coded responses 40 check-ins 13 free-text entries 0 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 968 / HI
Registered: 2021-05-08

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

2021-05-08
Registered in v-safe
2021-05-08
Dose 1 — Moderna
2021-05-08
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-05-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-05-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-05-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-05-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-05-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-05-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-05-15
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-05-22
Survey response — day 14, dose 1
MedDRA: Arthralgia, Feeling hot, Rash, Rash erythematous, Rash pruritic — Feeling: Fair

Free text: Large rash on shot arm: red, itchy, and hot to the touch. Began 8 days after vaccination, grew over 2 days to larger than the size of my hand (8 inches x 4 inches) Began fading 3 days later.Joint pain in same elbow developed at same time. Persists

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-29
Survey response — day 21, dose 1
MedDRA: Fatigue, Headache — Feeling: Good

Free text: Headache and fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-05
Dose 2 — Moderna
2021-06-05
Survey response — day 0, dose 2
MedDRA: Throat irritation, Throat tightness — Feeling: Good · Site: Pain

Free text: Scratchy/tight throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-06
Survey response — days 1–6 daily, dose 2
MedDRA: Throat irritation, Throat tightness — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Scratchy/tight throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-07
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site warmth, Oropharyngeal pain — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches

Free text: Mild sore throat, temperature increase at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-06-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · Fatigue or tiredness

Adult check-in
2021-06-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-06-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-06-12
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-06-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-28
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-07-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-07-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-07-17
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-09-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-12-04
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-12
Dose 3 — Moderna
2021-12-13
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-14
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Headache

Adult check-in
2021-12-15
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site warmth — Feeling: Good · Site: Pain, Swelling

Free text: Injection site is 10 degrees warmer than corresponding location on other arm

MedDRA releases: 2024-11 · check-in free text available
2021-12-16
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site warmth — Feeling: Good · Site: Redness

Free text: Injection site area is approximately 8 degrees F hotter than the rest of my skin

MedDRA releases: 2024-11 · check-in free text available
2021-12-17
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site warmth — Feeling: Good · Site: Redness

Free text: Injection site is approx 5 degrees F hotter than surrounding skin

MedDRA releases: 2024-11 · check-in free text available
2021-12-18
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-19
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-26
Survey response — day 14, dose 3
MedDRA: Oropharyngeal pain — Feeling: Fair

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-01-03
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-09
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-16
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-23
Survey response — day 42, dose 3
MedDRA: Oropharyngeal pain — Feeling: Good

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-03-13
Survey response — 3 months, dose 3
MedDRA: Costochondritis, Tinnitus — Feeling: Good

Free text: Hearing unexplained crackling noises; month-long costocondritus

MedDRA releases: 2024-11 · check-in free text available
2022-06-12
Survey response — 6 months, dose 3
MedDRA: Oropharyngeal pain — Feeling: Good

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-12-12
Survey response — 12 months, dose 3
MedDRA: Brain fog, Chest pain, Extrasystoles, Fatigue, Pericardial effusion — Feeling: Fair · Be unable to do your normal daily activities

Free text: Ectopic heartbeats and pericardial effusion; fatigue; chest pain; brain fog

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-08	Moderna
2	2021-06-05	Moderna
3	2021-12-12	Moderna	No

Free text

Release 8 — day 14, dose 1

2021-05-22

Symptoms: Large rash on shot arm: red, itchy, and hot to the touch. Began 8 days after vaccination, grew over 2 days to larger than the size of my hand (8 inches x 4 inches) Began fading 3 days later.Joint pain in same elbow developed at same time. Persists

Release 8 — day 21, dose 1

2021-05-29

Symptoms: Headache and fatigue

Release 8 — day 0, dose 2

2021-06-05

Systemic reaction (other): Scratchy/tight throat

Release 8 — days 1–6 daily, dose 2

2021-06-06

Systemic reaction (other): Scratchy/tight throat

2021-06-07

Systemic reaction (other): Mild sore throat, temperature increase at injection site

Release 10 — days 1–6 daily, dose 3

2021-12-15

Systemic reaction (other): Injection site is 10 degrees warmer than corresponding location on other arm

2021-12-16

Systemic reaction (other): Injection site area is approximately 8 degrees F hotter than the rest of my skin

2021-12-17

Systemic reaction (other): Injection site is approx 5 degrees F hotter than surrounding skin

Release 10 — day 14, dose 3

2021-12-26

Symptoms: Sore throat

Release 11 — day 42, dose 3

2022-01-23

Symptoms: Sore throat

Release 11 — 3 months, dose 3

2022-03-13

Symptoms: Hearing unexplained crackling noises; month-long costocondritus

Release 12 — 6 months, dose 3

2022-06-12

Symptoms: Sore throat

Release 12 — 12 months, dose 3

2022-12-12

Symptoms: Ectopic heartbeats and pericardial effusion; fatigue; chest pain; brain fog

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	Arthralgia	✓	✓	✓
SD	Brain fog	·	·	✓
SD	Chest pain	·	·	✓
SD	Costochondritis	·	·	✓
SD	Extrasystoles	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeling hot	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pericardial effusion	·	·	✓
SD	Rash	✓	✓	✓
SD	Rash erythematous	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SD	Tinnitus	·	·	✓
SRO	Injection site warmth	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Throat irritation	✓	✓	✓
SRO	Throat tightness	✓	✓	✓

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