ZF6-29528-70973

3 vaccinations 12 coded responses 25 check-ins 12 free-text entries 0 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 104 / NY
Registered: 2021-02-02

Relationship: Self
Race: Other
Ethnicity: 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
Registered in v-safe
2021-02-02
Dose 1 — Moderna
2021-02-02
Survey response — day 0, dose 1
MedDRA: Pain in extremity — Feeling: Good · Site: Pain · Muscle or body aches

Free text: My arm a little pain but nothing else

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

Adult check-in
2021-02-05
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Nausea — Feeling: Good · Nausea

Free text: This is my second doses and I left a little nausea and tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Nausea, Pain, Pain in extremity — Feeling: Good · Nausea

Free text: I feel like Tired a little body ache at first and a little nausea by my arm hurt a little

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — days 1–6 daily, dose 1
MedDRA: Headache — Feeling: Good

Free text: Slight headache it hurt a little

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Headache — Feeling: Good · Headache

Free text: Slight headache and Im tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Survey response — day 7, dose 1
MedDRA: Fatigue — Feeling: Good · Headache, Nausea

Free text: Very slightly and tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-23
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-27
Dose 2 — Moderna
2021-02-27
Survey response — day 0, dose 2
MedDRA: Headache, Pain in extremity — Feeling: Good · Muscle or body aches

Free text: My arm was sore and slightly headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue — Feeling: Good · Headache, Nausea

Free text: Mild and tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Slightly

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue — Feeling: Good · Headache, Nausea

Free text: Very slight but tiredness a little

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: Pruritus — Feeling: Good · Site: Itching · Headache

Free text: Slight itching around my wrist my hands

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — day 7, dose 2
MedDRA: Headache — Feeling: Good · Headache, Muscle or body aches

Free text: Slightly headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-31
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-04
Dose 3 — Moderna
2022-03-01
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-06-06
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-12-06
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-02	Moderna
2	2021-02-27	Moderna
3	2021-12-04	Moderna	No

Free text

Release 3 — day 0, dose 1

2021-02-02

Systemic reaction (other): My arm a little pain but nothing else

Release 3 — days 1–6 daily, dose 1

2021-02-05

Systemic reaction (other): This is my second doses and I left a little nausea and tired

2021-02-06

Systemic reaction (other): I feel like Tired a little body ache at first and a little nausea by my arm hurt a little

2021-02-07

Systemic reaction (other): Slight headache it hurt a little

2021-02-08

Systemic reaction (other): Slight headache and Im tired

Release 3 — day 7, dose 1

2021-02-09

Systemic reaction (other): Very slightly and tired

Release 4 — day 0, dose 2

2021-02-27

Systemic reaction (other): My arm was sore and slightly headache

Release 4 — days 1–6 daily, dose 2

2021-03-01

Systemic reaction (other): Mild and tired

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): Slightly

2021-03-04

Systemic reaction (other): Very slight but tiredness a little

2021-03-05

Systemic reaction (other): Slight itching around my wrist my hands

Release 5 — day 7, dose 2

2021-03-06

Systemic reaction (other): Slightly headache

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
SRO	Adverse reaction	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pruritus	✓	✓	✓

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