Y2E-27695-53154

5 vaccinations 10 coded responses 37 check-ins 10 free-text entries 0 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 327 / FL
Registered: 2021-12-08

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

2021-03-26
Dose 1 — Moderna
2021-04-23
Dose 2 — Moderna
2021-12-04
Dose 3 — Moderna
2021-12-08
Registered in v-safe
2021-12-08
Survey response — days 1–6 daily, dose 3
MedDRA: Chills, Cough, Diarrhoea, Fatigue, Headache, Injection site erythema, Lymphadenopathy, Myalgia, Nausea, Pyrexia — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Most of my symptoms happened a couple of days ago @ lasted 2 days: headache, arm muscle pain, nausea, diarrhea, fatigue, cough, fever, chills, swollen armpit lymph node, large red shot area.

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site erythema, Injection site pain, Injection site pruritus — Feeling: Fair · Site: Redness, Itching

Free text: Shot are still tender and itching but redness is receding.

MedDRA releases: 2024-11 · check-in free text available
2021-12-10
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site pain — Feeling: Fair · Site: Itching · Fatigue or tiredness

Free text: Immediate Shot site tender to touch.

MedDRA releases: 2024-11 · check-in free text available
2021-12-11
Health check-in — day 7, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-12-18
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-25
Health check-in — day 21, dose 3
Feeling: Good

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

Adult check-in
2022-01-08
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-01-15
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-05
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-09
Dose 4 — Moderna
2022-04-11
Survey response — days 1–6 daily, dose 4
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Swollen sore lymph node(s) in armpit on side of vaccine.

MedDRA releases: 2024-11 · check-in free text available
2022-04-12
Survey response — days 1–6 daily, dose 4
MedDRA: Asthma, Caffeine consumption, Palpitations — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Palpitations (but I'd also had caffeine) and asthma attack.

MedDRA releases: 2024-11 · check-in free text available
2022-04-13
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-14
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Redness, Itching · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-15
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Redness, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-16
Health check-in — day 7, dose 4
Feeling: Good · Site: Itching · Joint pains, Fatigue or tiredness

Adult check-in
2022-04-23
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-01
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-07
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-14
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-21
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-09
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-08
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in
2022-10-29
Dose 5 — Moderna
Co-administered: Flu
2022-10-30
Health check-in — days 1–6 daily, dose 5
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-10-31
Survey response — days 1–6 daily, dose 5
MedDRA: Hyperhidrosis — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Sweating

MedDRA releases: 2024-11 · check-in free text available
2022-11-01
Survey response — days 1–6 daily, dose 5
MedDRA: Cough — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Mild cough

MedDRA releases: 2024-11 · check-in free text available
2022-11-02
Survey response — days 1–6 daily, dose 5
MedDRA: Cough — Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Mid cough

MedDRA releases: 2024-11 · check-in free text available
2022-11-03
Survey response — days 1–6 daily, dose 5
MedDRA: Cough — Feeling: Fair · Site: Redness, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Mild cough

MedDRA releases: 2024-11 · check-in free text available
2022-11-04
Survey response — days 1–6 daily, dose 5
MedDRA: Cough — Feeling: Good · Site: Redness, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Mild cough

MedDRA releases: 2024-11 · check-in free text available
2022-11-05
Health check-in — day 7, dose 5
Feeling: Good · Site: Redness, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-11-14
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-11-19
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-26
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-12-03
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2022-12-10
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-30
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-04-29
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-26	Moderna	No
2	2021-04-23	Moderna	No
3	2021-12-04	Moderna	No
4	2022-04-09	Moderna	No
5	2022-10-29	Moderna	Flu

Free text

Release 10 — days 1–6 daily, dose 3

2021-12-08

Systemic reaction (other): Most of my symptoms happened a couple of days ago @ lasted 2 days: headache, arm muscle pain, nausea, diarrhea, fatigue, cough, fever, chills, swollen armpit lymph node, large red shot area.

2021-12-09

Systemic reaction (other): Shot are still tender and itching but redness is receding.

2021-12-10

Systemic reaction (other): Immediate Shot site tender to touch.

Release 11 — days 1–6 daily, dose 4

2022-04-11

Systemic reaction (other): Swollen sore lymph node(s) in armpit on side of vaccine.

2022-04-12

Systemic reaction (other): Palpitations (but I'd also had caffeine) and asthma attack.

Release 12 — days 1–6 daily, dose 5

2022-10-31

Systemic reaction (other): Sweating

2022-11-01

Systemic reaction (other): Mild cough

2022-11-02

Systemic reaction (other): Mid cough

2022-11-03

Systemic reaction (other): Mild cough

2022-11-04

Systemic reaction (other): Mild cough

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
SRO	Asthma	·	·	✓
SRO	Caffeine consumption	·	·	✓
SRO	Chills	·	·	✓
SRO	Cough	·	·	✓
SRO	Diarrhoea	·	·	✓
SRO	Fatigue	·	·	✓
SRO	Headache	·	·	✓
SRO	Hyperhidrosis	·	·	✓
SRO	Injection site erythema	·	·	✓
SRO	Injection site pain	·	·	✓
SRO	Injection site pruritus	·	·	✓
SRO	Lymph node pain	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Myalgia	·	·	✓
SRO	Nausea	·	·	✓
SRO	Palpitations	·	·	✓
SRO	Pyrexia	·	·	✓

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