Z9A-25698-16504

4 vaccinations 16 coded responses 45 check-ins 15 free-text entries 0 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 232 / VA
Registered: 2021-03-02

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

2021-02-02
Dose 1 — Moderna
2021-03-02
Registered in v-safe
2021-03-02
Dose 2 — Moderna
2021-03-02
Health check-in — day 0, dose 2
Feeling: Good · Site: Swelling · Abdominal pain

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Epistaxis, Sinus pain — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache

Free text: Sinus pain and slight nosebleed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia, Upper-airway cough syndrome — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache

Free text: Insomnia, postnasal drip

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Itching · Chills, Headache, Nausea

Adult check-in
2021-03-09
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · Chills, Headache

Adult check-in
2021-03-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-23
Survey response — day 21, dose 2
MedDRA: Arthralgia, Pelvic pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Joint pain in hands, shoulders and back; pelvic pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-06
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-13
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-01
Survey response — 3 months, dose 2
MedDRA: Pruritus, Rash, Rash pruritic — Feeling: Good

Free text: Itchy, bumpy rash on both forearms and back of hands

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-31
Survey response — 6 months, dose 2
MedDRA: Insomnia, Muscle strain, Tinea infection — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Strained back muscle, insomnia and ringworm infection

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-12-01
Dose 3 — Moderna
2021-12-01
Health check-in — day 0, dose 3
Feeling: Good · Site: Swelling · None

Adult check-in
2021-12-02
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches

Adult check-in
2021-12-04
Survey response — days 1–6 daily, dose 3
MedDRA: Anxiety, Depression — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Mild depression and anxiety

MedDRA releases: 2024-11 · check-in free text available
2021-12-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Itching · Joint pains, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site

Adult check-in
2021-12-06
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-12-07
Survey response — days 1–6 daily, dose 3
MedDRA: Depression — Feeling: Fair · Fatigue or tiredness

Free text: Mild depression

MedDRA releases: 2024-11 · check-in free text available
2021-12-08
Health check-in — day 7, dose 3
Feeling: Fair · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-12-15
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-12-22
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-12-29
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-01-07
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-01-12
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-04
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-06-03
Survey response — 6 months, dose 3
MedDRA: Rash, Rash maculo-papular, Rash pruritic — Feeling: Fair

Free text: Itchy maculopapular rash over my left collarbone

MedDRA releases: 2024-11 · check-in free text available
2022-10-17
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-10-17
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain, Itching · Joint pains, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-10-18
Survey response — days 1–6 daily, dose 4
MedDRA: Rash — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: A couple of flesh-colored, oblong bumps above my eyebrows

MedDRA releases: 2024-11 · check-in free text available
2022-10-19
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-10-20
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness · Joint pains, Abdominal pain

Adult check-in
2022-10-21
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Redness · Headache, Joint pains

Adult check-in
2022-10-22
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Redness · Headache, Abdominal pain

Adult check-in
2022-10-23
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Redness · Headache, Abdominal pain, Rash, not including the immediate area around the injection site

Adult check-in
2022-10-24
Survey response — day 7, dose 4
MedDRA: Dizziness, Muscle spasms — Feeling: Fair · Headache, Abdominal pain, Rash, not including the immediate area around the injection site

Free text: Muscle cramps, dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-10-31
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-11-07
Survey response — day 21, dose 4
MedDRA: Bladder irritation, Bladder pain — Feeling: Fair

Free text: Bladder irritation and pain

MedDRA releases: 2024-11 · check-in free text available
2022-11-14
Survey response — day 28, dose 4
MedDRA: Pre-existing disease, Rosacea — Feeling: Good

Free text: Worsening rosacea

MedDRA releases: 2024-11 · check-in free text available
2022-11-21
Survey response — day 35, dose 4
MedDRA: Abdominal pain, Fatigue, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Runny nose, fatigue, abdominal cramps

MedDRA releases: 2024-11 · check-in free text available
2022-11-28
Survey response — day 42, dose 4
MedDRA: Fatigue, Rash, Rash pruritic — Feeling: Fair

Free text: Itchy rash on chest, fatigue

MedDRA releases: 2024-11 · check-in free text available
2023-01-16
Survey response — 3 months, dose 4
MedDRA: Taste disorder — Feeling: Fair

MedDRA releases: 2024-11
2023-04-17
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-02	Moderna
2	2021-03-02	Moderna
3	2021-12-01	Moderna	No
4	2022-10-17	Pfizer-BioNTech	Flu

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-04

Systemic reaction (other): Dizziness

2021-03-05

Systemic reaction (other): Sinus pain and slight nosebleed

2021-03-06

Systemic reaction (other): Insomnia, postnasal drip

Release 6 — day 21, dose 2

2021-03-23

Symptoms: Joint pain in hands, shoulders and back; pelvic pain

Release 8 — 3 months, dose 2

2021-06-01

Symptoms: Itchy, bumpy rash on both forearms and back of hands

Release 9 — 6 months, dose 2

2021-08-31

Symptoms: Strained back muscle, insomnia and ringworm infection

Release 10 — days 1–6 daily, dose 3

2021-12-04

Systemic reaction (other): Mild depression and anxiety

2021-12-07

Systemic reaction (other): Mild depression

Release 11 — 6 months, dose 3

2022-06-03

Symptoms: Itchy maculopapular rash over my left collarbone

Release 12 — days 1–6 daily, dose 4

2022-10-18

Systemic reaction (other): A couple of flesh-colored, oblong bumps above my eyebrows

Release 12 — day 7, dose 4

2022-10-24

Systemic reaction (other): Muscle cramps, dizziness

Release 12 — day 21, dose 4

2022-11-07

Symptoms: Bladder irritation and pain

Release 12 — day 28, dose 4

2022-11-14

Symptoms: Worsening rosacea

Release 12 — day 35, dose 4

2022-11-21

Symptoms: Runny nose, fatigue, abdominal cramps

Release 12 — day 42, dose 4

2022-11-28

Symptoms: Itchy rash on chest, fatigue

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 pain	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Bladder irritation	·	·	✓
SD	Bladder pain	·	·	✓
SD	Fatigue	·	·	✓
SD	Insomnia	✓	·	✓
SD	Muscle strain	✓	·	✓
SD	Pelvic pain	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash maculo-papular	·	·	✓
SD	Rash pruritic	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	Rosacea	·	·	✓
SD	Taste disorder	·	·	✓
SD	Tinea infection	✓	·	✓
SRO	Anxiety	·	·	✓
SRO	Depression	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Epistaxis	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Muscle spasms	·	·	✓
SRO	Rash	·	·	✓
SRO	Sinus pain	✓	✓	✓
SRO	Upper-airway cough syndrome	✓	✓	✓

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