ZJY-17643-65676

4 vaccinations 8 coded responses 51 check-ins 8 free-text entries 0 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 973 / OR
Registered: 2021-01-07

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

2021-01-07
Registered in v-safe
2021-01-07
Dose 1 — Moderna
2021-01-07
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-14
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-21
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Insomnia — Feeling: Good · Be unable to do your normal daily activities

Free text: Pain in upper arm around injection site, swelling, redness and warmthStarted late in the evening, wasnt able to sleep much that nightStarted on the day of my last check-in, pain lasted about 36 hours, all symptoms improved after three days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-04
Dose 2 — Moderna
2021-02-04
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · Fatigue or tiredness, Nausea

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness · None

Adult check-in
2021-02-11
Health check-in — day 7, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-02-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-06
Survey response — 3 months, dose 2
MedDRA: Hypertensive urgency, Muscular weakness — Feeling: Fair · Be unable to do your normal daily activities

Free text: Hypertensive urgency, aggravated leg weakness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-05
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-26
Dose 3 — Moderna
2021-11-26
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2021-11-27
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-11-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-11-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Fatigue or tiredness

Adult check-in
2021-11-30
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Swelling of axillary lymphnodes

MedDRA releases: 2024-11 · check-in free text available
2021-12-01
Survey response — days 1–6 daily, dose 3
MedDRA: Localised oedema, Oedema peripheral — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness

Free text: Edema of arm and chest

MedDRA releases: 2024-11 · check-in free text available
2021-12-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-12-03
Health check-in — day 7, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache

Adult check-in
2021-12-10
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-17
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-31
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-07
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-25
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-29
Health check-in — 6 months, dose 3
Feeling: Good

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

Adult check-in
2022-09-11
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-09-12
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Swollen lymph nodes

MedDRA releases: 2024-11 · check-in free text available
2022-09-13
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy, Oedema — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Swollen lymph nodes, edema

MedDRA releases: 2024-11 · check-in free text available
2022-09-14
Survey response — days 1–6 daily, dose 4
MedDRA: Lymphadenopathy, Oedema — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Swollen lymphnodes, edema

MedDRA releases: 2024-11 · check-in free text available
2022-09-16
Survey response — days 1–6 daily, dose 4
MedDRA: Oedema — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches

Free text: Edema

MedDRA releases: 2024-11 · check-in free text available
2022-09-17
Health check-in — day 7, dose 4
Feeling: Good · Site: Swelling, Itching · Headache

Adult check-in
2022-09-24
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-01
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-10
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-15
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-10-22
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-03-11
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-04	Moderna
3	2021-11-26	Moderna	No
4	2022-09-10	Moderna	No

Free text

Release 2 — day 14, dose 1

2021-01-21

Symptoms: Pain in upper arm around injection site, swelling, redness and warmthStarted late in the evening, wasnt able to sleep much that nightStarted on the day of my last check-in, pain lasted about 36 hours, all symptoms improved after three days

Release 8 — 3 months, dose 2

2021-05-06

Symptoms: Hypertensive urgency, aggravated leg weakness

Release 10 — days 1–6 daily, dose 3

2021-11-30

Systemic reaction (other): Swelling of axillary lymphnodes

2021-12-01

Systemic reaction (other): Edema of arm and chest

Release 12 — days 1–6 daily, dose 4

2022-09-12

Systemic reaction (other): Swollen lymph nodes

2022-09-13

Systemic reaction (other): Swollen lymph nodes, edema

2022-09-14

Systemic reaction (other): Swollen lymphnodes, edema

2022-09-16

Systemic reaction (other): Edema

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	Hypertensive urgency	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Muscular weakness	✓	✓	✓
SRO	Localised oedema	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Oedema	·	·	✓
SRO	Oedema peripheral	·	·	✓

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