Y36-33247-75019

3 vaccinations 10 coded responses 23 check-ins 10 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 992 / WA
Registered: 2021-02-07

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

2021-01-30
Dose 1 — Moderna
2021-02-07
Registered in v-safe
2021-02-07
Survey response — day 7, dose 1
MedDRA: COVID-19 — Feeling: Good · Site: Pain, Redness, Swelling · Headache

Free text: COVID arm one week after

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Survey response — day 14, dose 1
MedDRA: Erythema, Immunisation reaction — Feeling: Fair

Free text: I had a big red spot on my arm . I looked it up and the name of it is COVID arm ! It got bigger then slowly went away .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Survey response — day 21, dose 1
MedDRA: Fatigue, Headache, Pain in extremity — Feeling: Fair

Free text: A headache in the afternoon. And fatigue.and my arm is still sore.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Dose 2 — Moderna
2021-02-27
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Spacey thinking

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches

Free text: Itchy skin on legs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

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

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-06
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-20
Survey response — day 21, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Very fatigued

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — day 28, dose 2
MedDRA: Fatigue, Feeling abnormal, Memory impairment — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue and brain fog and forgetfulness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-29
Survey response — 3 months, dose 2
MedDRA: Blood glucose increased — Feeling: Fair

Free text: Since my last shot my blood sugar has been a bit higher.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-28
Survey response — 6 months, dose 2
MedDRA: Balance disorder, Brain fog, Ear pain, Oropharyngeal pain — Feeling: Fair

Free text: Ear pain, foggy thinking , off balance and today sore throat.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-20
Dose 3 — Moderna
2021-10-25
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-11-01
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-20
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-22
Survey response — 6 months, dose 3
MedDRA: Abdominal pain upper, Malaise — Feeling: Fair

Free text: Stomach hurts and feeling a bit sick off and on .

MedDRA releases: 2024-11 · check-in free text available
2022-09-20
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-30	Moderna
2	2021-02-27	Moderna
3	2021-09-20	Moderna	No

Free text

Release 3 — day 7, dose 1

2021-02-07

Systemic reaction (other): COVID arm one week after

Release 4 — day 14, dose 1

2021-02-13

Symptoms: I had a big red spot on my arm . I looked it up and the name of it is COVID arm ! It got bigger then slowly went away .

Release 4 — day 21, dose 1

2021-02-20

Symptoms: A headache in the afternoon. And fatigue.and my arm is still sore.

Release 4 — days 1–6 daily, dose 2

2021-02-28

Systemic reaction (other): Spacey thinking

2021-03-01

Systemic reaction (other): Itchy skin on legs

Release 6 — day 21, dose 2

2021-03-20

Symptoms: Very fatigued

Release 6 — day 28, dose 2

2021-03-27

Symptoms: Fatigue and brain fog and forgetfulness.

Release 8 — 3 months, dose 2

2021-05-29

Symptoms: Since my last shot my blood sugar has been a bit higher.

Release 9 — 6 months, dose 2

2021-08-28

Symptoms: Ear pain, foggy thinking , off balance and today sore throat.

Release 11 — 6 months, dose 3

2022-03-22

Symptoms: Stomach hurts and feeling a bit sick off and on .

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	Abdominal pain upper	·	·	✓
SD	Balance disorder	✓	·	✓
SD	Blood glucose increased	✓	✓	✓
SD	Brain fog	✓	·	✓
SD	Ear pain	✓	·	✓
SD	Erythema	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Immunisation reaction	✓	✓	✓
SD	Malaise	·	·	✓
SD	Memory impairment	✓	✓	✓
SD	Oropharyngeal pain	✓	·	✓
SD	Pain in extremity	✓	✓	✓
SRO	COVID-19	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Pruritus	✓	✓	✓

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