U62-16197-57219

5 vaccinations 3 coded responses 49 check-ins 3 free-text entries 0 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 956 / CA
Registered: 2021-04-01

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

2021-03-06
Dose 1 — Moderna
2021-04-01
Registered in v-safe
2021-04-01
Survey response — day 21, dose 1
MedDRA: Fatigue, Myalgia, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Muscle aches day after vaccine #1, very fatigued for 10 days after vaccine #1, arm pain fir 3days after vaccine #1

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Dose 2 — Moderna
2021-04-03
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea

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

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Very itchy all over body- started last night

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-10
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-25
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-03
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-04
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-10-23
Dose 3 — Moderna
2021-10-26
Survey response — days 1–6 daily, dose 3
MedDRA: Headache, Myalgia, Nausea — Feeling: Fair · Site: Pain

Free text: Had headache and nausea day of shot, muscle aches day after

MedDRA releases: 2024-11 · check-in free text available
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2021-10-30
Health check-in — day 7, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-13
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-11-22
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-11-27
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-04
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-22
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-04-24
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-07-15
Dose 4 — Moderna
2022-07-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-07-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Muscle or body aches

Adult check-in
2022-07-24
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-07-29
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-08-07
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-08-14
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-08-19
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-08-26
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2023-01-15
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in
2023-01-26
Dose 5 — Moderna
2023-01-27
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2023-01-28
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2023-01-29
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2023-01-30
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2023-01-31
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2023-02-01
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Headache, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2023-02-02
Health check-in — day 7, dose 5
Feeling: Fair · Muscle or body aches

Adult check-in
2023-02-09
Health check-in — day 14, dose 5
Feeling: Fair

Adult check-in
2023-02-16
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2023-02-23
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2023-03-02
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2023-03-09
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2023-04-28
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-06	Moderna
2	2021-04-03	Moderna
3	2021-10-23	Moderna	No
4	2022-07-15	Moderna	No
5	2023-01-26	Moderna	No

Free text

Release 6 — day 21, dose 1

2021-04-01

Symptoms: Muscle aches day after vaccine #1, very fatigued for 10 days after vaccine #1, arm pain fir 3days after vaccine #1

Release 7 — days 1–6 daily, dose 2

2021-04-06

Systemic reaction (other): Very itchy all over body- started last night

Release 10 — days 1–6 daily, dose 3

2021-10-26

Systemic reaction (other): Had headache and nausea day of shot, muscle aches day after

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	Fatigue	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SRO	Headache	·	·	✓
SRO	Myalgia	·	·	✓
SRO	Nausea	·	·	✓
SRO	Pruritus	✓	✓	✓

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