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ZCF-21320-90702

4 vaccinations 25 coded responses 43 check-ins 24 free-text entries 0 call cases
Sex
Female
Age at first dose
36-40
ZIP prefix
550 / MN
Registered
2021-04-21
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
F8F-78655-50540 Child or adolescent in my care · Female · 2022-10-09
BR8-14090-23503 Child or adolescent in my care · Female · 2022-10-09

Timeline

  1. 2021-04-15
    Dose 1 — Moderna
  2. 2021-04-21
    Registered in v-safe
  3. 2021-04-21
    Survey response — days 1–6 daily, dose 1
    MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good
    Free text: Swollen and sore lymph node under my left armpit. I got the shot in my left arm.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-04-22
    Survey response — day 7, dose 1
    MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good
    Free text: Swollen and sore lymph node under my left armpit (same side as injection site).
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-05-01
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  6. 2021-05-06
    Survey response — day 21, dose 1
    MedDRA: Ear pruritus, Fatigue, Pain, Pre-existing disease, Sneezing — Feeling: Fair · Be unable to work
    Free text: Fatigue, body aches, sneezing, itchy ears (internal ear). Allergy symptoms.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-05-13
    Dose 2 — Moderna
  8. 2021-05-13
    Health check-in — day 0, dose 2
    Feeling: Fair · Site: Pain, Swelling · None
    Adult check-in
  9. 2021-05-14
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, 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
  10. 2021-05-16
    Survey response — days 1–6 daily, dose 2
    MedDRA: Muscle spasms — Feeling: Good · Site: Redness, Itching
    Free text: Muscle spasm under my left eye. I'm sure it's not related. I haven't eaten a banana lately.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-05-18
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  12. 2021-05-19
    Survey response — days 1–6 daily, dose 2
    MedDRA: Blepharospasm, Muscle spasms — Feeling: Good
    Free text: Muscle spasm under my left eye and muscle spasm in my right thigh.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-05-20
    Survey response — day 7, dose 2
    MedDRA: Muscle spasms — Feeling: Good
    Free text: Under my left eye is still having a miscle spasm. I took some vitamins today. We'll see if it goes away now.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-05-27
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-06-03
    Survey response — day 21, dose 2
    MedDRA: Eye disorder — Feeling: Good
    Free text: Under eye spasms have turned into eye muscle clenching up. I should have mentioned that at the last check-in, since it was worsening/clenching then as well and not just the spasms.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-06-10
    Survey response — day 28, dose 2
    MedDRA: Blepharospasm, Headache, Nasopharyngitis, Rhinorrhoea — Feeling: Good · Be unable to work, Be unable to do your normal daily activities
    Free text: I got a cold. Runny nose, headache. Day 2 today. Under eye twitch went away.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-06-17
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-06-24
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-08-12
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-11-11
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-12-16
    Dose 3 — Moderna
  22. 2021-12-17
    Survey response — days 1–6 daily, dose 3
    MedDRA: Asthenopia, Fatigue, Lymphadenopathy — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Swollen lymph node under the arm I had my vaccine in. My face looks tired/eyes aren't fully open.
    MedDRA releases: 2024-11 · check-in free text available
  23. 2021-12-18
    Survey response — days 1–6 daily, dose 3
    MedDRA: Injection site pain, Lymphadenopathy — Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness
    Free text: Quite swollen lymph node under armpit...same side as injection site. Also, to note: I had mild pain in the location of injection site that lasted from the time of the second injection up until present.
    MedDRA releases: 2024-11 · check-in free text available
  24. 2021-12-19
    Survey response — days 1–6 daily, dose 3
    MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness
    Free text: Swollen lymph node on lower left side of neck and also still swollen lymph node under left armpit. Injection site was left arm.
    MedDRA releases: 2024-11 · check-in free text available
  25. 2021-12-21
    Survey response — days 1–6 daily, dose 3
    MedDRA: Eye pruritus, Lymphadenopathy — Feeling: Good · Site: Pain
    Free text: Swollen ltmph node under armpit and on neck same side as injection (left side). Right eye has been itchy.
    MedDRA releases: 2024-11 · check-in free text available
  26. 2021-12-22
    Survey response — days 1–6 daily, dose 3
    MedDRA: Asthenopia, Dry eye, Lymphadenopathy — Feeling: Good · Site: Pain
    Free text: Swollen lymph node under left armpit (same side as injection site). Swollen lymph node in my neck seems to have gone away. My eyes are dry and tired.
    MedDRA releases: 2024-11 · check-in free text available
  27. 2021-12-23
    Survey response — day 7, dose 3
    MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain, Swelling
    Free text: Swollen lymph node in armpit, same side as injection site.
    MedDRA releases: 2024-11 · check-in free text available
  28. 2022-01-01
    Survey response — day 14, dose 3
    MedDRA: Cough, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Fair
    Free text: Sore throat, runny nose, cough. Took 2 at-home covid tests during different stages of the illness and they were negative.
    MedDRA releases: 2024-11 · check-in free text available
  29. 2022-01-06
    Survey response — day 21, dose 3
    MedDRA: Bone pain, Nasopharyngitis, Office visit, SARS-CoV-2 test negative — Feeling: Good
    Free text: Mastoid bone is sore after having a cold (2 negative at-home covid tests). Went to dr. She says no treatment until/if I develop a fever.
    MedDRA releases: 2024-11 · check-in free text available
  30. 2022-01-13
    Survey response — day 28, dose 3
    MedDRA: Pain — Feeling: Good
    Free text: Pain behind right ear is still present.
    MedDRA releases: 2024-11 · check-in free text available
  31. 2022-01-20
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  32. 2022-01-27
    Survey response — day 42, dose 3
    MedDRA: Anxiety — Feeling: Good
    Free text: Anxiety the past couple of days.
    MedDRA releases: 2024-11 · check-in free text available
  33. 2022-03-17
    Survey response — 3 months, dose 3
    MedDRA: Injection site pain — Feeling: Good
    Free text: Still have the achy arm at least once per day. Site of vaccine injection.
    MedDRA releases: 2024-11 · check-in free text available
  34. 2022-06-16
    Survey response — 6 months, dose 3
    MedDRA: Erythema, Localised infection, Pruritus — Feeling: Good
    Free text: I had itchy legs and scratched my ankle enough to open the skin. I then acquired an infection in this area that was quite large. The infection is gone, but my ankle is still red/purple in the area of the infection.
    MedDRA releases: 2024-11 · check-in free text available
  35. 2022-10-07
    Dose 4 — Moderna
    Co-administered: Flu
  36. 2022-10-09
    Health check-in — day 35, dose 1, dependent
    Feeling: Good
    Adult check-in
  37. 2022-10-09
    Health check-in — days 1–6 daily, dose 4
    Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Nausea · Be unable to do your normal daily activities
    Adult check-in
  38. 2022-10-10
    Survey response — days 1–6 daily, dose 4
    MedDRA: Arthropod bite, Skin lesion — Feeling: Good · Site: Pain
    Free text: 1 small lesion appeared on the left side of my waist. I suspect a bug bite, though.
    MedDRA releases: 2024-11 · check-in free text available
  39. 2022-10-11
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Site: Pain · None
    Adult check-in
  40. 2022-10-12
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Site: Pain · None
    Adult check-in
  41. 2022-10-14
    Health check-in — day 7, dose 4
    Feeling: Good · None
    Adult check-in
  42. 2022-10-21
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  43. 2022-10-28
    Survey response — day 21, dose 4
    MedDRA: Lymphadenopathy, Nasal congestion, Nasopharyngitis — Feeling: Fair
    Free text: Extremely mild cold symptoms. Mild nasal congestion. Swollen lymph node under left armpit (same side as vaccine was given).
    MedDRA releases: 2024-11 · check-in free text available
  44. 2022-11-04
    Survey response — day 28, dose 4
    MedDRA: Cough, Fatigue, Insomnia, Respiratory tract congestion, Rhinorrhoea — Feeling: Fair
    Free text: Congestion, runny nose, cough, fatigue, insomnia.
    MedDRA releases: 2024-11 · check-in free text available
  45. 2022-11-11
    Survey response — day 35, dose 4
    MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good
    Free text: I have always had a fluttery heart/extra heart beat sometimes. It's picked up lately. I didn't mention it on the last check-in, but figured I would mention it now, just in case.
    MedDRA releases: 2024-11 · check-in free text available
  46. 2022-11-18
    Health check-in — day 42, dose 4
    Feeling: Fair
    Adult check-in
  47. 2023-01-06
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  48. 2023-04-07
    Survey response — 6 months, dose 4
    MedDRA: Injection site pain — Feeling: Good
    MedDRA releases: 2024-11

Vaccinations

DoseDateManufacturerCo-administered
12021-04-15Moderna
22021-05-13Moderna
32021-12-16Moderna No
42022-10-07Moderna Flu

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-21

Systemic reaction (other): Swollen and sore lymph node under my left armpit. I got the shot in my left arm.

Release 7 — day 7, dose 1

2021-04-22

Systemic reaction (other): Swollen and sore lymph node under my left armpit (same side as injection site).

Release 8 — day 21, dose 1

2021-05-06

Symptoms: Fatigue, body aches, sneezing, itchy ears (internal ear). Allergy symptoms.

Release 8 — days 1–6 daily, dose 2

2021-05-16

Systemic reaction (other): Muscle spasm under my left eye. I'm sure it's not related. I haven't eaten a banana lately.

2021-05-19

Systemic reaction (other): Muscle spasm under my left eye and muscle spasm in my right thigh.

Release 8 — day 7, dose 2

2021-05-20

Systemic reaction (other): Under my left eye is still having a miscle spasm. I took some vitamins today. We'll see if it goes away now.

Release 8 — day 21, dose 2

2021-06-03

Symptoms: Under eye spasms have turned into eye muscle clenching up. I should have mentioned that at the last check-in, since it was worsening/clenching then as well and not just the spasms.

Release 9 — day 28, dose 2

2021-06-10

Symptoms: I got a cold. Runny nose, headache. Day 2 today. Under eye twitch went away.

Release 10 — days 1–6 daily, dose 3

2021-12-17

Systemic reaction (other): Swollen lymph node under the arm I had my vaccine in. My face looks tired/eyes aren't fully open.

2021-12-18

Systemic reaction (other): Quite swollen lymph node under armpit...same side as injection site. Also, to note: I had mild pain in the location of injection site that lasted from the time of the second injection up until present.

2021-12-19

Systemic reaction (other): Swollen lymph node on lower left side of neck and also still swollen lymph node under left armpit. Injection site was left arm.

2021-12-21

Systemic reaction (other): Swollen ltmph node under armpit and on neck same side as injection (left side). Right eye has been itchy.

2021-12-22

Systemic reaction (other): Swollen lymph node under left armpit (same side as injection site). Swollen lymph node in my neck seems to have gone away. My eyes are dry and tired.

Release 10 — day 7, dose 3

2021-12-23

Systemic reaction (other): Swollen lymph node in armpit, same side as injection site.

Release 10 — day 14, dose 3

2022-01-01

Symptoms: Sore throat, runny nose, cough. Took 2 at-home covid tests during different stages of the illness and they were negative.

Release 10 — day 21, dose 3

2022-01-06

Symptoms: Mastoid bone is sore after having a cold (2 negative at-home covid tests). Went to dr. She says no treatment until/if I develop a fever.

Release 10 — day 28, dose 3

2022-01-13

Symptoms: Pain behind right ear is still present.

Release 11 — day 42, dose 3

2022-01-27

Symptoms: Anxiety the past couple of days.

Release 11 — 3 months, dose 3

2022-03-17

Symptoms: Still have the achy arm at least once per day. Site of vaccine injection.

Release 12 — 6 months, dose 3

2022-06-16

Symptoms: I had itchy legs and scratched my ankle enough to open the skin. I then acquired an infection in this area that was quite large. The infection is gone, but my ankle is still red/purple in the area of the infection.

Release 12 — days 1–6 daily, dose 4

2022-10-10

Systemic reaction (other): 1 small lesion appeared on the left side of my waist. I suspect a bug bite, though.

Release 12 — day 21, dose 4

2022-10-28

Symptoms: Extremely mild cold symptoms. Mild nasal congestion. Swollen lymph node under left armpit (same side as vaccine was given).

Release 12 — day 28, dose 4

2022-11-04

Symptoms: Congestion, runny nose, cough, fatigue, insomnia.

Release 12 — day 35, dose 4

2022-11-11

Symptoms: I have always had a fluttery heart/extra heart beat sometimes. It's picked up lately. I didn't mention it on the last check-in, but figured I would mention it now, just in case.

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
SDAnxiety · · ✓
SDBlepharospasm ✓ ✓ ✓
SDBone pain · · ✓
SDCondition aggravated · · ✓
SDCough · · ✓
SDEar pruritus ✓ ✓ ✓
SDErythema · · ✓
SDEye disorder ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDInjection site pain · · ✓
SDInsomnia · · ✓
SDLocalised infection · · ✓
SDLymphadenopathy · · ✓
SDNasal congestion · · ✓
SDNasopharyngitis ✓ ✓ ✓
SDOffice visit · · ✓
SDOropharyngeal pain · · ✓
SDPain ✓ ✓ ✓
SDPre-existing disease ✓ ✓ ✓
SDPruritus · · ✓
SDRespiratory tract congestion · · ✓
SDRhinorrhoea ✓ ✓ ✓
SDSARS-CoV-2 test negative · · ✓
SDSneezing ✓ ✓ ✓
SROArthropod bite · · ✓
SROAsthenopia · · ✓
SROBlepharospasm ✓ ✓ ✓
SRODry eye · · ✓
SROEye pruritus · · ✓
SROFatigue · · ✓
SROInjection site pain · · ✓
SROLymph node pain ✓ ✓ ✓
SROLymphadenopathy ✓ ✓ ✓
SROMuscle spasms ✓ ✓ ✓
SROSkin lesion · · ✓

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

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