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Z8B-16045-00233

4 vaccinations 15 coded responses 36 check-ins 15 free-text entries 0 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
972 / OR
Registered
2021-01-26
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-17
    Dose 1 — Moderna
  2. 2021-01-26
    Registered in v-safe
  3. 2021-01-26
    Health check-in — day 7, dose 1
    Feeling: Good · Site: Pain, Redness, Swelling, Itching · Muscle or body aches
    Adult check-in
  4. 2021-01-31
    Survey response — day 14, dose 1
    MedDRA: Erythema, Muscular weakness, Myalgia, Pruritus — Feeling: Fair
    Free text: Redness and itching on L arm is worse and arm is weak and muscle is sore.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-02-07
    Survey response — day 21, dose 1
    MedDRA: Arthralgia, Headache, Injection site pain, Rash macular — Feeling: Fair
    Free text: Below injexn site is painful and blotchy red 3/4 around upper arm just below injexn site. Shldr joint is painful. Headaches.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-14
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  7. 2021-02-17
    Dose 2 — Moderna
  8. 2021-02-21
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea
    Adult check-in
  9. 2021-02-22
    Survey response — days 1–6 daily, dose 2
    MedDRA: Cough, Increased upper airway secretion, Productive cough, Sneezing — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Thick mucus at back of throat, coughing and some sneezing.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-02-23
    Survey response — days 1–6 daily, dose 2
    MedDRA: Hypogeusia, Increased viscosity of upper respiratory secretion — Feeling: Good · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: Still have thick mucus running down back of throat and diminished sense of taste
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-02-24
    Health check-in — day 7, dose 2
    Feeling: Good · Site: Pain · Headache, Muscle or body aches
    Adult check-in
  12. 2021-03-03
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-03-10
    Survey response — day 21, dose 2
    MedDRA: Cough, Headache, Increased viscosity of upper respiratory secretion, Secretion discharge, Sneezing — Feeling: Fair
    Free text: Sneezing, cough, thick mucus, headache
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-03-17
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-03-24
    Health check-in — day 35, dose 2
    Feeling: Fair
    Adult check-in
  16. 2021-04-02
    Survey response — day 42, dose 2
    MedDRA: Depression — Feeling: Good · Be unable to do your normal daily activities
    Free text: Depression
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-05-19
    Health check-in — 3 months, dose 2
    Feeling: Fair
    Adult check-in
  18. 2021-08-18
    Survey response — 6 months, dose 2
    MedDRA: Cough, Fatigue, Productive cough — Feeling: Fair
    Free text: Fatigue, cough, thicker phlegm tho clear
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  19. 2021-10-26
    Dose 3 — Moderna
  20. 2021-10-26
    Health check-in — day 0, dose 3
    Feeling: Good · None
    Adult check-in
  21. 2021-10-28
    Survey response — days 1–6 daily, dose 3
    MedDRA: Dizziness, Gingival pain, Noninfective gingivitis — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Dizziness, inflamed & painful gums
    MedDRA releases: 2024-11 · check-in free text available
  22. 2021-10-29
    Survey response — days 1–6 daily, dose 3
    MedDRA: Gingival discomfort — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: Gum irritation
    MedDRA releases: 2024-11 · check-in free text available
  23. 2021-10-30
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  24. 2021-10-31
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  25. 2021-11-02
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  26. 2021-11-09
    Survey response — day 14, dose 3
    MedDRA: Back pain, Bone pain, Pain in extremity — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Pain in toes, feet, shins & mid back
    MedDRA releases: 2024-11 · check-in free text available
  27. 2021-11-16
    Survey response — day 21, dose 3
    MedDRA: Pain in extremity — Feeling: Good
    Free text: Shin pain
    MedDRA releases: 2024-11 · check-in free text available
  28. 2021-11-23
    Survey response — day 28, dose 3
    MedDRA: Bone pain, Myalgia — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Bone & muscle pain
    MedDRA releases: 2024-11 · check-in free text available
  29. 2021-11-30
    Survey response — day 35, dose 3
    MedDRA: Depression — Feeling: Good
    Free text: Depression
    MedDRA releases: 2024-11 · check-in free text available
  30. 2021-12-07
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  31. 2022-01-25
    Survey response — 3 months, dose 3
    MedDRA: Pain in extremity — Feeling: Fair
    Free text: Bilateral shin pain
    MedDRA releases: 2024-11 · check-in free text available
  32. 2022-04-06
    Dose 4 — Moderna
  33. 2022-04-14
    Health check-in — day 7, dose 4
    Feeling: Fair · None
    Adult check-in
  34. 2022-04-20
    Health check-in — day 14, dose 4
    Feeling: Fair
    Adult check-in
  35. 2022-04-28
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  36. 2022-05-04
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  37. 2022-05-11
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  38. 2022-05-18
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  39. 2022-07-06
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  40. 2022-10-05
    Survey response — 6 months, dose 4
    MedDRA: Cough, Sneezing — Feeling: Good
    Free text: Sneeze, cough
    MedDRA releases: 2024-11 · check-in free text available
  41. 2023-04-06
    Health check-in — 12 months, dose 4
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-17Moderna
22021-02-17Moderna
32021-10-26Moderna No
42022-04-06Moderna No

Free text

Release 3 — day 14, dose 1

2021-01-31

Symptoms: Redness and itching on L arm is worse and arm is weak and muscle is sore.

Release 3 — day 21, dose 1

2021-02-07

Symptoms: Below injexn site is painful and blotchy red 3/4 around upper arm just below injexn site. Shldr joint is painful. Headaches.

Release 4 — days 1–6 daily, dose 2

2021-02-22

Systemic reaction (other): Thick mucus at back of throat, coughing and some sneezing.

2021-02-23

Systemic reaction (other): Still have thick mucus running down back of throat and diminished sense of taste

Release 5 — day 21, dose 2

2021-03-10

Symptoms: Sneezing, cough, thick mucus, headache

Release 6 — day 42, dose 2

2021-04-02

Symptoms: Depression

Release 9 — 6 months, dose 2

2021-08-18

Symptoms: Fatigue, cough, thicker phlegm tho clear

Release 10 — days 1–6 daily, dose 3

2021-10-28

Systemic reaction (other): Dizziness, inflamed & painful gums

2021-10-29

Systemic reaction (other): Gum irritation

Release 10 — day 14, dose 3

2021-11-09

Symptoms: Pain in toes, feet, shins & mid back

Release 10 — day 21, dose 3

2021-11-16

Symptoms: Shin pain

Release 10 — day 28, dose 3

2021-11-23

Symptoms: Bone & muscle pain

Release 10 — day 35, dose 3

2021-11-30

Symptoms: Depression

Release 11 — 3 months, dose 3

2022-01-25

Symptoms: Bilateral shin pain

Release 12 — 6 months, dose 4

2022-10-05

Symptoms: Sneeze, cough

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

FieldPreferred term2021-092023-042024-11
SDArthralgia ✓ ✓ ✓
SDBack pain · · ✓
SDBone pain · · ✓
SDCough ✓ ✓ ✓
SDDepression ✓ ✓ ✓
SDErythema ✓ ✓ ✓
SDFatigue ✓ · ✓
SDHeadache ✓ ✓ ✓
SDIncreased viscosity of upper respiratory secretion · · ✓
SDInjection site pain ✓ ✓ ✓
SDMuscular weakness ✓ ✓ ✓
SDMyalgia ✓ ✓ ✓
SDPain in extremity · · ✓
SDProductive cough ✓ · ✓
SDPruritus ✓ ✓ ✓
SDRash macular ✓ ✓ ✓
SDSecretion discharge ✓ ✓ ○
SDSneezing ✓ ✓ ✓
SROCough ✓ ✓ ✓
SRODizziness · · ✓
SROGingival discomfort · · ✓
SROGingival pain · · ✓
SROHypogeusia ✓ ✓ ✓
SROIncreased upper airway secretion ✓ ✓ ✓
SROIncreased viscosity of upper respiratory secretion ✓ ✓ ✓
SRONoninfective gingivitis · · ✓
SROProductive cough ✓ ✓ ✓
SROSneezing ✓ ✓ ✓

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

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