Z5L-69907-86243

4 vaccinations 11 coded responses 41 check-ins 10 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 895 / NV
Registered: 2020-12-31

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

2020-12-31
Registered in v-safe
2020-12-31
Dose 1 — Moderna
2020-12-31
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches

Adult check-in
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache

Adult check-in
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-07
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
Survey response — day 14, dose 1
MedDRA: Dizziness, Headache, Nervousness — Feeling: Fair

Free text: Headache, light headed, a bit shaky feeling inside

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-28
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-01-29
Dose 2 — Moderna
2021-01-29
Health check-in — day 0, dose 2
Feeling: Fair · Muscle or body aches

Adult check-in
2021-01-30
Survey response — days 1–6 daily, dose 2
MedDRA: Burning sensation, Paraesthesia — Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Prickly & burning feeling on my back & feet

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Muscle or body aches

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Muscle or body aches

Adult check-in
2021-02-02
Survey response — days 1–6 daily, dose 2
MedDRA: Burning sensation — Feeling: Fair · Site: Redness, Itching · Muscle or body aches

Free text: Burning in feet & back

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Muscle or body aches

Adult check-in
2021-02-05
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-19
Survey response — day 21, dose 2
MedDRA: Arthralgia, Burning feet syndrome, Condition aggravated, Pre-existing disease — Feeling: Fair

Free text: This past week my feet are burning & joints hurting like after my 2nd vaccine. I believe it has flared up my neuropathy but kept pushing myself to keep busy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-05
Survey response — day 35, dose 2
MedDRA: Abdominal discomfort, Flushing, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Stomach upset all week & face has felt flush several times & a few headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — day 42, dose 2
MedDRA: Abdominal discomfort, Dyspepsia — Feeling: Good · Be unable to do your normal daily activities

Free text: Stomach was upset & burning first part of week but doing better now

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-07-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-24
Dose 3 — Moderna
2022-01-29
Survey response — 12 months, dose 2
MedDRA: Chills, Pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Chills & aching day after booster

MedDRA releases: 2024-11 · check-in free text available
2022-10-25
Dose 4 — Moderna
2022-10-26
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Chills, Headache · Be unable to do your normal daily activities

Adult check-in
2022-10-27
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-28
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-29
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Itching · Headache

Adult check-in
2022-10-30
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Itching · Headache

Adult check-in
2022-10-31
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache

Adult check-in
2022-11-01
Health check-in — day 7, dose 4
Feeling: Good · Site: Itching · None

Adult check-in
2022-11-08
Survey response — day 14, dose 4
MedDRA: Headache — Feeling: Good · Be unable to do your normal daily activities

Free text: A few Headaches this past week.

MedDRA releases: 2024-11 · check-in free text available
2022-11-15
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-22
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-29
Survey response — day 35, dose 4
MedDRA: Headache — Feeling: Good

Free text: Headache over the weekend

MedDRA releases: 2024-11 · check-in free text available
2022-12-06
Survey response — day 42, dose 4
MedDRA: Headache, Nasopharyngitis — Feeling: Fair

Free text: Headache & fill like catching a cold

MedDRA releases: 2024-11 · check-in free text available
2023-01-24
Survey response — 3 months, dose 4
MedDRA: Gastrointestinal disorder — Feeling: Fair

MedDRA releases: 2024-11
2023-04-25
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-31	Moderna
2	2021-01-29	Moderna
3	2022-01-24	Moderna	No
4	2022-10-25	Moderna	No

Free text

Release 2 — day 14, dose 1

2021-01-14

Symptoms: Headache, light headed, a bit shaky feeling inside

Release 3 — days 1–6 daily, dose 2

2021-01-30

Systemic reaction (other): Prickly & burning feeling on my back & feet

2021-02-02

Systemic reaction (other): Burning in feet & back

Release 4 — day 21, dose 2

2021-02-19

Symptoms: This past week my feet are burning & joints hurting like after my 2nd vaccine. I believe it has flared up my neuropathy but kept pushing myself to keep busy.

Release 5 — day 35, dose 2

2021-03-05

Symptoms: Stomach upset all week & face has felt flush several times & a few headaches

Release 5 — day 42, dose 2

2021-03-12

Symptoms: Stomach was upset & burning first part of week but doing better now

Release 11 — 12 months, dose 2

2022-01-29

Symptoms: Chills & aching day after booster

Release 12 — day 14, dose 4

2022-11-08

Symptoms: A few Headaches this past week.

Release 12 — day 35, dose 4

2022-11-29

Symptoms: Headache over the weekend

Release 12 — day 42, dose 4

2022-12-06

Symptoms: Headache & fill like catching a cold

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 discomfort	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Burning feet syndrome	✓	✓	✓
SD	Chills	·	·	✓
SD	Condition aggravated	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dyspepsia	✓	✓	✓
SD	Flushing	✓	✓	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Headache	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Nervousness	✓	✓	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SRO	Burning sensation	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓

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