Y5W-29804-11597

2 vaccinations 6 coded responses 20 check-ins 6 free-text entries 0 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 191 / PA
Registered: 2021-01-19

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

2021-01-19
Registered in v-safe
2021-01-19
Dose 1 — Moderna
2021-01-19
Survey response — day 0, dose 1
MedDRA: Paraesthesia, Paraesthesia oral — Feeling: Fair · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Tingling sensation in lips and cheeks

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Survey response — days 1–6 daily, dose 1
MedDRA: Urticaria — Feeling: Fair · Site: Redness, Itching · Chills, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Hives

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: Anxiety, Chest discomfort, Chest pain, Chills, Cough, Dizziness, Energy increased, Erythema, Fatigue, Headache, Hypopnoea, Immediate post-injection reaction, Injection site pruritus, Injection site rash, Injection site urticaria, Lip swelling, Nasopharyngitis, Oedema peripheral, Oropharyngeal pain, Paraesthesia, Paraesthesia oral, Pruritus, Pyrexia, Rhinorrhoea, Self-medication, Sneezing, Swelling face — Feeling: Good · Site: Redness, Itching · Chills

Free text: Tuesday, January 19th: received the shot at 1:30 pm, developed chills and a headache immediately. Started having chest pains/tightness around 2, which lasted until 6 pm. I had shallow breathing but felt like it was more of an anxious response to chest pains. There was a tingling sensation in my lips and face, with a little puffiness. Around 7 pm I developed a 100.6 F fever (temporal temp). Felt exhausted. Wednesday: Woke up feeling energized, like I could run a marathon. Went downhill around noon- felt dizzy, severe chills and exhaustion, cough, and raise in temperature (100.2 F, temporal). Thursday: Woke up feeling like I had a cold: sore throat, cough, chills, runny nose, and sneezing. Developed a rash along my left arm where I had the shot, accompanied by hives- itchy. Took an antihistamine and it slowly subsided. Friday: Woke up with a rash along my left arm, hives, and mildly swollen armpits- itchy. Still have cold symptoms. Saturday: Cold symptoms still. Only redness is on my left arm, the opposite side of my elbow (where an iv is usually placed).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-26
Health check-in — day 7, dose 1
Feeling: Good · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-02-04
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-11
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-16
Dose 2 — Moderna
2021-02-16
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-04
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-11
Survey response — day 21, dose 2
MedDRA: Gastrointestinal disorder, Headache, Rhinorrhoea — Feeling: Fair

Free text: Gastrointestinal distress and elevated temperature, but no fever. Runny nose and headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — day 28, dose 2
MedDRA: Abdominal distension, Abdominal pain upper — Feeling: Poor · Be unable to do your normal daily activities

Free text: Severe gastro pains. Pains and bloating began after second dosage but were mild, now they are severe

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Survey response — day 42, dose 2
MedDRA: Body temperature increased, Chills — Feeling: Good

Free text: Temperature of 100.3, but just only really have mild chills

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2022-02-18
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-19	Moderna
2	2021-02-16	Moderna

Free text

Release 2 — day 0, dose 1

2021-01-19

Systemic reaction (other): Tingling sensation in lips and cheeks

Release 2 — days 1–6 daily, dose 1

2021-01-22

Systemic reaction (other): Hives

2021-01-23

Systemic reaction (other): Tuesday, January 19th: received the shot at 1:30 pm, developed chills and a headache immediately. Started having chest pains/tightness around 2, which lasted until 6 pm. I had shallow breathing but felt like it was more of an anxious response to chest pains. There was a tingling sensation in my lips and face, with a little puffiness. Around 7 pm I developed a 100.6 F fever (temporal temp). Felt exhausted. Wednesday: Woke up feeling energized, like I could run a marathon. Went downhill around noon- felt dizzy, severe chills and exhaustion, cough, and raise in temperature (100.2 F, temporal). Thursday: Woke up feeling like I had a cold: sore throat, cough, chills, runny nose, and sneezing. Developed a rash along my left arm where I had the shot, accompanied by hives- itchy. Took an antihistamine and it slowly subsided. Friday: Woke up with a rash along my left arm, hives, and mildly swollen armpits- itchy. Still have cold symptoms. Saturday: Cold symptoms still. Only redness is on my left arm, the opposite side of my elbow (where an iv is usually placed).

Release 5 — day 21, dose 2

2021-03-11

Symptoms: Gastrointestinal distress and elevated temperature, but no fever. Runny nose and headache

Release 5 — day 28, dose 2

2021-03-16

Symptoms: Severe gastro pains. Pains and bloating began after second dosage but were mild, now they are severe

Release 6 — day 42, dose 2

2021-03-30

Symptoms: Temperature of 100.3, but just only really have mild chills

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 distension	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Body temperature increased	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Gastrointestinal disorder	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SRO	Anxiety	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Energy increased	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hypopnoea	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	Injection site rash	✓	✓	✓
SRO	Injection site urticaria	✓	✓	✓
SRO	Lip swelling	✓	✓	✓
SRO	Nasopharyngitis	✓	✓	✓
SRO	Oedema peripheral	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Paraesthesia oral	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Sneezing	✓	✓	✓
SRO	Swelling face	✓	✓	✓
SRO	Urticaria	✓	✓	✓

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