Y67-12352-58907

4 vaccinations 12 coded responses 41 check-ins 12 free-text entries 0 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 906 / CA
Registered: 2021-03-09

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
2021-03-09
Registered in v-safe
2021-03-09
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary mass — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches

Free text: Large lump in the left atmpit area, close to breast.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain, Redness, Swelling · Headache

Free text: Armpit lymph node area has a large swollen area.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-03-13
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-20
Survey response — day 14, dose 1
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Swollen lymph nodes on both sides where the neck meets the jaws. Lasted for 2 days, gone today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-03
Dose 2 — Moderna
2021-04-03
Health check-in — day 0, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Loss of personal independence in daily activities — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Cannot function doing daily tasks requiring help all day.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

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

Free text: Irritably all day, every day. Disoriented also

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Irritability — Feeling: Fair · Site: Pain, Swelling

Free text: Irritable every day.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Irritability — Feeling: Fair · Fatigue or tiredness

Free text: Irritable again

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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
2021-04-24
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
Survey response — day 35, dose 2
MedDRA: Erythema, Pruritus, Self-medication, Skin exfoliation — Feeling: Good

Free text: Skin above the eyes are very itchy, scaly, and red. Benedryl or creams don't help with the itching and redness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Survey response — day 42, dose 2
MedDRA: Eyelid rash, Pruritus, Self-medication — Feeling: Good

Free text: Rash above my eyes (where eyeshadow would go). Extreme itching with no relief from Benedryl. Taking an allergy medication, no relief.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-03
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-02
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-27
Dose 3 — Pfizer-BioNTech
2021-10-27
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Migraine, Pyrexia — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Fever, migraine

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-19
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-26
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-15
Dose 4 — Pfizer-BioNTech
2022-04-16
Survey response — days 1–6 daily, dose 4
MedDRA: Decreased appetite — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lack of appetite

MedDRA releases: 2024-11 · check-in free text available
2022-04-17
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-18
Survey response — days 1–6 daily, dose 4
MedDRA: Hyperhidrosis, Night sweats — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Nausea

Free text: Heavy sweating at night

MedDRA releases: 2024-11 · check-in free text available
2022-04-19
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2022-04-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2022-04-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-22
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-04-29
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-06
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-13
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-21
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-27
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-10-14
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-06	Moderna
2	2021-04-03	Moderna
3	2021-10-27	Pfizer-BioNTech	No
4	2022-04-15	Pfizer-BioNTech	No

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-09

Systemic reaction (other): Large lump in the left atmpit area, close to breast.

2021-03-10

Systemic reaction (other): Armpit lymph node area has a large swollen area.

Release 6 — day 14, dose 1

2021-03-20

Symptoms: Swollen lymph nodes on both sides where the neck meets the jaws. Lasted for 2 days, gone today.

Release 6 — days 1–6 daily, dose 2

2021-04-04

Systemic reaction (other): Cannot function doing daily tasks requiring help all day.

Release 7 — days 1–6 daily, dose 2

2021-04-06

Systemic reaction (other): Irritably all day, every day. Disoriented also

2021-04-07

Systemic reaction (other): Irritable every day.

2021-04-08

Systemic reaction (other): Irritable again

Release 8 — day 35, dose 2

2021-05-08

Symptoms: Skin above the eyes are very itchy, scaly, and red. Benedryl or creams don't help with the itching and redness.

Release 8 — day 42, dose 2

2021-05-15

Symptoms: Rash above my eyes (where eyeshadow would go). Extreme itching with no relief from Benedryl. Taking an allergy medication, no relief.

Release 10 — days 1–6 daily, dose 3

2021-10-28

Systemic reaction (other): Fever, migraine

Release 11 — days 1–6 daily, dose 4

2022-04-16

Systemic reaction (other): Lack of appetite

2022-04-18

Systemic reaction (other): Heavy sweating at night

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	Erythema	✓	✓	✓
SD	Eyelid rash	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Skin exfoliation	✓	✓	✓
SRO	Axillary mass	✓	✓	✓
SRO	Decreased appetite	·	·	✓
SRO	Disorientation	✓	✓	✓
SRO	Hyperhidrosis	·	·	✓
SRO	Irritability	✓	✓	✓
SRO	Loss of personal independence in daily activities	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Migraine	·	·	✓
SRO	Night sweats	·	·	✓
SRO	Pyrexia	·	·	✓

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