Z74-76402-99641

2 vaccinations 7 coded responses 25 check-ins 7 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 333 / FL
Registered: 2021-01-30

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

2021-01-29
Dose 1 — Moderna
2021-01-30
Registered in v-safe
2021-01-30
Survey response — days 1–6 daily, dose 1
MedDRA: Immediate post-injection reaction, Rash — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: The rash was down near the inside of arm right above my elbow. It started about 40 min after the injection. Its gone now

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-01
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site erythema, Injection site pain, Injection site swelling, Injection site urticaria, Injection site warmth — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Last night I had a very large red swollen hot welt on my arm running from the injection site down. And a temp of 99.8. It was hot and painful to the touch. Its better today but still there.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Survey response — days 1–6 daily, dose 1
MedDRA: Erythema, Injection site erythema, Pyrexia — Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness

Free text: Some redness on chest and collar bone area last night and still on arm below injection site. Temp last night after yesterdays check in of 99.5.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness · Headache, Fatigue or tiredness

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache

Adult check-in
2021-02-05
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain · None

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

Adult check-in
2021-02-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-26
Dose 2 — Moderna
2021-02-26
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

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

Adult check-in
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Vision blurred — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Blurred vision for both distance and close up.Also some dizziness.

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: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-05
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-03-12
Health check-in — day 14, dose 2
Feeling: Good

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

Free text: HeadachesRash on arm right below where vaccinated and then a few hours later down near wrist. Took an antihistamine and used cortaid and that helped after awhile. Gone after a few hours.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-04
Survey response — day 35, dose 2
MedDRA: Headache, Rash, Self-medication — Feeling: Fair

Free text: Rash on forearm at elbow area on arm of injection. Lasted a couple of hours until antihistamine worked. Also headache in temples continues off and on.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-28
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-28
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-03-01
Survey response — 12 months, dose 2
MedDRA: Dizziness, Fatigue, Headache, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Dizzy nauseous headache tired

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-29	Moderna
2	2021-02-26	Moderna

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-30

Systemic reaction (other): The rash was down near the inside of arm right above my elbow. It started about 40 min after the injection. Its gone now

2021-02-01

Systemic reaction (other): Last night I had a very large red swollen hot welt on my arm running from the injection site down. And a temp of 99.8. It was hot and painful to the touch. Its better today but still there.

2021-02-02

Systemic reaction (other): Some redness on chest and collar bone area last night and still on arm below injection site. Temp last night after yesterdays check in of 99.5.

Release 4 — days 1–6 daily, dose 2

2021-03-01

Systemic reaction (other): Blurred vision for both distance and close up.Also some dizziness.

Release 6 — day 21, dose 2

2021-03-21

Symptoms: HeadachesRash on arm right below where vaccinated and then a few hours later down near wrist. Took an antihistamine and used cortaid and that helped after awhile. Gone after a few hours.

Release 6 — day 35, dose 2

2021-04-04

Symptoms: Rash on forearm at elbow area on arm of injection. Lasted a couple of hours until antihistamine worked. Also headache in temples continues off and on.

Release 11 — 12 months, dose 2

2022-03-01

Symptoms: Dizzy nauseous headache tired

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	Dizziness	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Nausea	·	·	✓
SD	Rash	✓	✓	✓
SD	Self-medication	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Injection site urticaria	✓	✓	✓
SRO	Injection site warmth	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Vision blurred	✓	✓	✓

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