Z4Z-21035-40052

4 vaccinations 9 coded responses 40 check-ins 9 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 985 / WA
Registered: 2021-01-21

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

2021-01-21
Registered in v-safe
2021-01-21
Dose 1 — Moderna
2021-01-21
Survey response — day 0, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: No S/S of any kind

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: Fatigue — Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Free text: Fatigue cleared by mid day.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-04
Survey response — day 14, dose 1
MedDRA: Injection site pruritus — Feeling: Good

Free text: Itching at injection site. Cleared after 2-3 days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-18
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-23
Dose 2 — Moderna
2021-02-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-26
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Good · Site: Redness, Swelling, Itching · Headache

Free text: HA possibly related to seasonal allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · Headache

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-02
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-16
Survey response — day 21, dose 2
MedDRA: Cough, Fatigue — Feeling: Good

Free text: Mild cough, fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-06
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-25
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-24
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-12
Dose 3 — Moderna
2022-02-23
Survey response — 12 months, dose 2
MedDRA: Cough, Fatigue, Headache, Influenza like illness, Oropharyngeal pain, SARS-CoV-2 test negative — Feeling: Good

Free text: Mild flu like , short lived (mild no-productive cough, intermittent headache, mild sore throat). Afebrile. Extreme fatigue that lasted approximately 3 weeks. Sequential home testing for Covid negative x three.

MedDRA releases: 2024-11 · check-in free text available
2022-04-26
Dose 4 — Moderna
2022-04-27
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-28
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Redness, Swelling · Fatigue or tiredness

Adult check-in
2022-04-29
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-30
Survey response — days 1–6 daily, dose 4
MedDRA: Somnolence — Feeling: Good · Site: Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Had trouble staying awake today

MedDRA releases: 2024-11 · check-in free text available
2022-05-01
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2022-05-02
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-03
Health check-in — day 7, dose 4
Feeling: Fair · Site: Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-10
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-17
Survey response — day 21, dose 4
MedDRA: Fatigue, Somnolence — Feeling: Good · Be unable to do your normal daily activities

Free text: Extreme fatigue, easing now. I found I was napping two-three hours each day. I'm not usually a mapper.

MedDRA releases: 2024-11 · check-in free text available
2022-05-24
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-31
Survey response — day 35, dose 4
MedDRA: Fatigue — Feeling: Fair

Free text: Fatigue, sometimes overwhelming. MD appointment this week. DOE exercising.

MedDRA releases: 2024-11 · check-in free text available
2022-06-07
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-27
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-25
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-26
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-21	Moderna
2	2021-02-23	Moderna
3	2021-12-12	Moderna	No
4	2022-04-26	Moderna	No

Free text

Release 2 — day 0, dose 1

2021-01-21

Systemic reaction (other): No S/S of any kind

Release 2 — days 1–6 daily, dose 1

2021-01-22

Systemic reaction (other): Fatigue cleared by mid day.

Release 3 — day 14, dose 1

2021-02-04

Symptoms: Itching at injection site. Cleared after 2-3 days.

Release 4 — days 1–6 daily, dose 2

2021-02-26

Systemic reaction (other): HA possibly related to seasonal allergies

Release 5 — day 21, dose 2

2021-03-16

Symptoms: Mild cough, fatigue

Release 11 — 12 months, dose 2

2022-02-23

Symptoms: Mild flu like , short lived (mild no-productive cough, intermittent headache, mild sore throat). Afebrile. Extreme fatigue that lasted approximately 3 weeks. Sequential home testing for Covid negative x three.

Release 11 — days 1–6 daily, dose 4

2022-04-30

Systemic reaction (other): Had trouble staying awake today

Release 11 — day 21, dose 4

2022-05-17

Symptoms: Extreme fatigue, easing now. I found I was napping two-three hours each day. I'm not usually a mapper.

Release 11 — day 35, dose 4

2022-05-31

Symptoms: Fatigue, sometimes overwhelming. MD appointment this week. DOE exercising.

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	Cough	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Influenza like illness	·	·	✓
SD	Injection site pruritus	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Somnolence	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Somnolence	·	·	✓

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