ZG4-63964-07473

4 vaccinations 25 coded responses 55 check-ins 24 free-text entries 0 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 907 / CA
Registered: 2021-02-13

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

463-31700-65515 Child or adolescent in my care · Female · 2021-07-26

YD2-13013-63623 Child or adolescent in my care · Female · 2021-11-22

Timeline Vaccinations Free text MedDRA terms

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-02-13
Registered in v-safe
2021-02-13
Dose 1 — Moderna
2021-02-13
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-18
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary pain — Feeling: Good · Headache, Fatigue or tiredness

Free text: right arm pit painful (I got my shot in my right arm)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary pain — Feeling: Good · Fatigue or tiredness

Free text: Arm pit pain - moderate pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Survey response — day 7, dose 1
MedDRA: Axillary pain — Feeling: Good · Headache

Free text: Arm pit pain - moderate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-13
Dose 2 — Moderna
2021-03-13
Health check-in — day 0, dose 2
Feeling: Fair · None

Adult check-in
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: Oedema peripheral — Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Swollen arm pit - moderate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — days 1–6 daily, dose 2
MedDRA: Oedema peripheral — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Swollen arm pit - moderate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — days 1–6 daily, dose 2
MedDRA: Oedema peripheral — Feeling: Fair · Site: Pain, Redness, Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Arm pit swollen - moderate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — days 1–6 daily, dose 2
MedDRA: Oedema peripheral — Feeling: Fair · Site: Pain, Redness, Swelling, Itching

Free text: Swollen arm pit - moderate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — days 1–6 daily, dose 2
MedDRA: Oedema peripheral — Feeling: Fair · Site: Redness, Itching · Headache

Free text: Arm pit swelling - moderate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — days 1–6 daily, dose 2
MedDRA: Oedema peripheral — Feeling: Good · Site: Itching

Free text: Swollen arm pit - moderate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — day 7, dose 2
MedDRA: Axillary pain — Feeling: Good · Site: Itching · Headache, Fatigue or tiredness

Free text: Swollen armpit - moderate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-12
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-11
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-20
Dose 3 — Moderna
2021-11-20
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-11-21
Survey response — days 1–6 daily, dose 3
MedDRA: Oedema peripheral, Swelling — Feeling: Fair · Site: Pain, Swelling · Headache

Free text: Swollen arm pit and collar bone on side of shot - right.

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain

Free text: Swollen arm pit and collar bone - lymph node.

MedDRA releases: 2024-11 · check-in free text available
2021-11-23
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy, Oedema peripheral — Feeling: Good · Site: Pain, Redness

Free text: Swollen armpit on right where I got the shot and lymph node around collar bone.

MedDRA releases: 2024-11 · check-in free text available
2021-11-24
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain

Free text: Swollen arm pit and collar bone lymph node

MedDRA releases: 2024-11 · check-in free text available
2021-11-25
Survey response — days 1–6 daily, dose 3
MedDRA: Oedema peripheral — Feeling: Good

Free text: Swollen armpit on injection arm

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Survey response — days 1–6 daily, dose 3
MedDRA: Oedema peripheral — Feeling: Good

Free text: Swollen right arm pit

MedDRA releases: 2024-11 · check-in free text available
2021-11-27
Survey response — day 7, dose 3
MedDRA: Oedema peripheral — Feeling: Good

Free text: Swollen right arm pit

MedDRA releases: 2024-11 · check-in free text available
2021-12-04
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-11
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-18
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-25
Health check-in — day 35, dose 3
Feeling: Good

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

Adult check-in
2022-02-19
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-21
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-09
Dose 4 — Moderna
2022-10-09
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-10-10
Survey response — days 1–6 daily, dose 4
MedDRA: Fatigue — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Tiredness

MedDRA releases: 2024-11 · check-in free text available
2022-10-11
Survey response — days 1–6 daily, dose 4
MedDRA: Oedema peripheral — Feeling: Good · Site: Pain, Redness · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Swollen armpit.

MedDRA releases: 2024-11 · check-in free text available
2022-10-12
Survey response — days 1–6 daily, dose 4
MedDRA: Oedema peripheral — Feeling: Good · Site: Pain, Redness · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Swollen armpit

MedDRA releases: 2024-11 · check-in free text available
2022-10-13
Survey response — days 1–6 daily, dose 4
MedDRA: Oedema peripheral — Feeling: Good · Site: Pain, Redness · Muscle or body aches, Fatigue or tiredness

Free text: Swollen armpit

MedDRA releases: 2024-11 · check-in free text available
2022-10-14
Survey response — days 1–6 daily, dose 4
MedDRA: Oedema peripheral — Feeling: Good · Site: Redness · Fatigue or tiredness

Free text: Swollen arm pit

MedDRA releases: 2024-11 · check-in free text available
2022-10-15
Survey response — days 1–6 daily, dose 4
MedDRA: Oedema peripheral — Feeling: Good · Site: Pain, Redness

Free text: Swollen arm pit

MedDRA releases: 2024-11 · check-in free text available
2022-10-16
Survey response — day 7, dose 4
MedDRA: Oedema peripheral — Feeling: Good · Site: Pain, Redness

Free text: Swollen arm pit

MedDRA releases: 2024-11 · check-in free text available
2022-10-23
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-30
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-06
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-15
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-20
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-01-08
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-04-09
Survey response — 6 months, dose 4
MedDRA: Ageusia, Anosmia — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-13	Moderna
2	2021-03-13	Moderna
3	2021-11-20	Moderna	No
4	2022-10-09	Moderna	No

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-18

Systemic reaction (other): right arm pit painful (I got my shot in my right arm)

2021-02-19

Systemic reaction (other): Arm pit pain - moderate pain

Release 4 — day 7, dose 1

2021-02-20

Systemic reaction (other): Arm pit pain - moderate

Release 5 — days 1–6 daily, dose 2

2021-03-14

Systemic reaction (other): Swollen arm pit - moderate

2021-03-15

Systemic reaction (other): Swollen arm pit - moderate

2021-03-16

Systemic reaction (other): Arm pit swollen - moderate

2021-03-17

Systemic reaction (other): Swollen arm pit - moderate

2021-03-18

Systemic reaction (other): Arm pit swelling - moderate

Release 6 — days 1–6 daily, dose 2

2021-03-19

Systemic reaction (other): Swollen arm pit - moderate

Release 6 — day 7, dose 2

2021-03-20

Systemic reaction (other): Swollen armpit - moderate

Release 10 — days 1–6 daily, dose 3

2021-11-21

Systemic reaction (other): Swollen arm pit and collar bone on side of shot - right.

2021-11-22

Systemic reaction (other): Swollen arm pit and collar bone - lymph node.

2021-11-23

Systemic reaction (other): Swollen armpit on right where I got the shot and lymph node around collar bone.

2021-11-24

Systemic reaction (other): Swollen arm pit and collar bone lymph node

2021-11-25

Systemic reaction (other): Swollen armpit on injection arm

2021-11-26

Systemic reaction (other): Swollen right arm pit

Release 10 — day 7, dose 3

2021-11-27

Systemic reaction (other): Swollen right arm pit

Release 12 — days 1–6 daily, dose 4

2022-10-10

Systemic reaction (other): Tiredness

2022-10-11

Systemic reaction (other): Swollen armpit.

2022-10-12

Systemic reaction (other): Swollen armpit

2022-10-13

Systemic reaction (other): Swollen armpit

2022-10-14

Systemic reaction (other): Swollen arm pit

2022-10-15

Systemic reaction (other): Swollen arm pit

Release 12 — day 7, dose 4

2022-10-16

Systemic reaction (other): Swollen arm pit

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	Ageusia	·	·	✓
SD	Anosmia	·	·	✓
SRO	Axillary pain	✓	✓	✓
SRO	Fatigue	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Oedema peripheral	✓	✓	✓
SRO	Swelling	·	·	✓

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