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ZQY-12684-09076

4 vaccinations 18 coded responses 48 check-ins 18 free-text entries 0 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
067 / CT
Registered
2021-03-19
Relationship
Self
Race
White
Ethnicity
N/A

Timeline

  1. 2021-03-17
    Dose 1 — Moderna
  2. 2021-03-19
    Registered in v-safe
  3. 2021-03-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Fatigue or tiredness
    Adult check-in
  4. 2021-03-20
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  5. 2021-03-21
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-03-22
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-03-23
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-03-24
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-03-31
    Health check-in — day 14, dose 1
    Feeling: Fair
    Adult check-in
  10. 2021-04-08
    Survey response — day 21, dose 1
    MedDRA: Abdominal discomfort — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Stomach issues
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-04-21
    Dose 2 — Moderna
  12. 2021-04-21
    Survey response — day 0, dose 2
    MedDRA: No adverse event — Feeling: Fair · Site: Pain · Fever · Headache, Nausea
    Free text: No
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-04-22
    Survey response — days 1–6 daily, dose 2
    MedDRA: Insomnia — Feeling: Fair · Site: Pain · Nausea · Be unable to do your normal daily activities
    Free text: Insomnia
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-04-23
    Survey response — days 1–6 daily, dose 2
    MedDRA: Self-medication — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Free text: My normal temperature is between 96-97. Right now it is 98.1. Goes up at night. Taking tylenol.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-04-24
    Survey response — days 1–6 daily, dose 2
    MedDRA: Insomnia — Feeling: Fair · Site: Pain · Be unable to do your normal daily activities
    Free text: I have had insomnia since the first vaccine. It has been worse since the second vaccine. I have not found any relationship between the vaccine and insomnia. But I thought you would want this info since info is still being researched.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-04-25
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-04-26
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fever · None
    Adult check-in
  18. 2021-04-27
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-04-28
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-05-05
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-05-12
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-05-19
    Survey response — day 28, dose 2
    MedDRA: Insomnia — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities
    Free text: Foe the past few weeks I have been experiencing extremely severe insomnia. I am curious to know if this is a side effect of the vaccine that noone has considered.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  23. 2021-05-26
    Survey response — day 35, dose 2
    MedDRA: Insomnia — Feeling: Fair
    Free text: Insomnia
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  24. 2021-06-02
    Survey response — day 42, dose 2
    MedDRA: Abdominal pain upper, Diarrhoea, Nausea — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Bad stomach pain, nausea, diarrhea .
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  25. 2021-07-21
    Survey response — 3 months, dose 2
    MedDRA: Emergency care, Epistaxis — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: I was on the local emergency room due to profuse nose bleeds. I do not have a history of nosebleeds. The cause was not determined by the ER Doctor.
    MedDRA releases: 2024-11 · check-in free text available
  26. 2021-10-21
    Survey response — 6 months, dose 2
    MedDRA: Abdominal pain upper, Anxiety, Epistaxis — Feeling: Poor
    Free text: Upper stomach pain. I still worry about the bloody nose I experienced in July. I did read that a small percentage of people experience bloody noses from the vaccine.
    MedDRA releases: 2024-11 · check-in free text available
  27. 2021-11-17
    Dose 3 — Moderna
  28. 2021-11-19
    Health check-in — days 1–6 daily, dose 3
    Feeling: Poor · Site: Pain, Swelling · Nausea, Diarrhea · Be unable to do your normal daily activities
    Adult check-in
  29. 2021-11-20
    Survey response — days 1–6 daily, dose 3
    MedDRA: Injection site pain — Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Free text: Pain from when the nurse injected the needle. But before she injected the vaccine itself (Mrna).
    MedDRA releases: 2024-11 · check-in free text available
  30. 2021-11-21
    Survey response — days 1–6 daily, dose 3
    MedDRA: Injection site pain, Paraesthesia — Feeling: Fair · Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: The vax was very painful when it was stuck into my arm. Next the nurse shot the Moderna solution into my arm, and the pain increased. I do not have any covid arm pain, but I do have pins and needles in my shoulder and upper neck.
    MedDRA releases: 2024-11 · check-in free text available
  31. 2021-11-22
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · None
    Adult check-in
  32. 2021-11-23
    Survey response — days 1–6 daily, dose 3
    MedDRA: Paraesthesia — Feeling: Good · Joint pains
    Free text: Pins and needles in vaccine shoulder and neck
    MedDRA releases: 2024-11 · check-in free text available
  33. 2021-11-24
    Health check-in — day 7, dose 3
    Feeling: Fair · Fatigue or tiredness, Abdominal pain
    Adult check-in
  34. 2021-12-01
    Health check-in — day 14, dose 3
    Feeling: Fair
    Adult check-in
  35. 2021-12-08
    Health check-in — day 21, dose 3
    Feeling: Fair
    Adult check-in
  36. 2021-12-15
    Survey response — day 28, dose 3
    MedDRA: Condition aggravated, Pre-existing disease, Rhinorrhoea — Feeling: Fair
    Free text: Runny nose, sneezing more often than usual.
    MedDRA releases: 2024-11 · check-in free text available
  37. 2021-12-22
    Survey response — day 35, dose 3
    MedDRA: Chills, Rhinorrhoea, Sneezing — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Sneezing all day yesterday with runny nose. Chills also. Maybe it is allergies. I don't know.
    MedDRA releases: 2024-11 · check-in free text available
  38. 2021-12-29
    Health check-in — day 42, dose 3
    Feeling: Fair
    Adult check-in
  39. 2022-02-16
    Health check-in — 3 months, dose 3
    Feeling: Fair
    Adult check-in
  40. 2022-04-21
    Dose 4 — Moderna
  41. 2022-04-21
    Health check-in — day 0, dose 4
    Feeling: Fair · Site: Pain · Fever · None
    Adult check-in
  42. 2022-04-22
    Health check-in — days 1–6 daily, dose 4
    Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Nausea · Be unable to do your normal daily activities
    Adult check-in
  43. 2022-04-23
    Health check-in — days 1–6 daily, dose 4
    Feeling: Fair · Site: Pain · Fatigue or tiredness, Rash, not including the immediate area around the injection site
    Adult check-in
  44. 2022-04-24
    Health check-in — days 1–6 daily, dose 4
    Feeling: Poor · Fever · Muscle or body aches, Nausea, Diarrhea · Be unable to do your normal daily activities
    Adult check-in
  45. 2022-04-25
    Survey response — days 1–6 daily, dose 4
    MedDRA: Rash — Feeling: Fair · Site: Pain, Itching · Joint pains, Muscle or body aches, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities
    Free text: Rash on my shoulder and back area. Near arm of shot.
    MedDRA releases: 2024-11 · check-in free text available
  46. 2022-04-26
    Health check-in — days 1–6 daily, dose 4
    Feeling: Fair · Site: Itching · Joint pains, Muscle or body aches, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities
    Adult check-in
  47. 2022-04-27
    Health check-in — days 1–6 daily, dose 4
    Feeling: Fair · Site: Redness, Itching · Fever · Joint pains, Muscle or body aches, Rash, not including the immediate area around the injection site
    Adult check-in
  48. 2022-04-28
    Health check-in — day 7, dose 4
    Feeling: Poor · Site: Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities
    Adult check-in
  49. 2022-05-05
    Health check-in — day 14, dose 4
    Feeling: Fair
    Adult check-in
  50. 2022-05-12
    Survey response — day 21, dose 4
    MedDRA: Diarrhoea, Nausea, Rash — Feeling: Poor
    Free text: Diarrhea, nausea, rash
    MedDRA releases: 2024-11 · check-in free text available
  51. 2022-05-19
    Health check-in — day 28, dose 4
    Feeling: Fair
    Adult check-in
  52. 2022-05-26
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  53. 2022-10-20
    Survey response — 6 months, dose 4
    MedDRA: Back pain — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Back aches
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-03-17Moderna
22021-04-21Moderna
32021-11-17Moderna No
42022-04-21Moderna No

Free text

Release 7 — day 21, dose 1

2021-04-08

Symptoms: Stomach issues

Release 7 — day 0, dose 2

2021-04-21

Systemic reaction (other): No

Release 7 — days 1–6 daily, dose 2

2021-04-22

Systemic reaction (other): Insomnia

2021-04-23

Systemic reaction (other): My normal temperature is between 96-97. Right now it is 98.1. Goes up at night. Taking tylenol.

2021-04-24

Systemic reaction (other): I have had insomnia since the first vaccine. It has been worse since the second vaccine. I have not found any relationship between the vaccine and insomnia. But I thought you would want this info since info is still being researched.

Release 8 — day 28, dose 2

2021-05-19

Symptoms: Foe the past few weeks I have been experiencing extremely severe insomnia. I am curious to know if this is a side effect of the vaccine that noone has considered.

Release 8 — day 35, dose 2

2021-05-26

Symptoms: Insomnia

Release 8 — day 42, dose 2

2021-06-02

Symptoms: Bad stomach pain, nausea, diarrhea .

Release 9 — 3 months, dose 2

2021-07-21

Symptoms: I was on the local emergency room due to profuse nose bleeds. I do not have a history of nosebleeds. The cause was not determined by the ER Doctor.

Release 10 — 6 months, dose 2

2021-10-21

Symptoms: Upper stomach pain. I still worry about the bloody nose I experienced in July. I did read that a small percentage of people experience bloody noses from the vaccine.

Release 10 — days 1–6 daily, dose 3

2021-11-20

Systemic reaction (other): Pain from when the nurse injected the needle. But before she injected the vaccine itself (Mrna).

2021-11-21

Systemic reaction (other): The vax was very painful when it was stuck into my arm. Next the nurse shot the Moderna solution into my arm, and the pain increased. I do not have any covid arm pain, but I do have pins and needles in my shoulder and upper neck.

2021-11-23

Systemic reaction (other): Pins and needles in vaccine shoulder and neck

Release 10 — day 28, dose 3

2021-12-15

Symptoms: Runny nose, sneezing more often than usual.

Release 10 — day 35, dose 3

2021-12-22

Symptoms: Sneezing all day yesterday with runny nose. Chills also. Maybe it is allergies. I don't know.

Release 11 — days 1–6 daily, dose 4

2022-04-25

Systemic reaction (other): Rash on my shoulder and back area. Near arm of shot.

Release 11 — day 21, dose 4

2022-05-12

Symptoms: Diarrhea, nausea, rash

Release 12 — 6 months, dose 4

2022-10-20

Symptoms: Back aches

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
SDAbdominal discomfort ✓ ✓ ✓
SDAbdominal pain upper ✓ ✓ ✓
SDAnxiety · · ✓
SDBack pain · · ✓
SDChills · · ✓
SDCondition aggravated · · ✓
SDDiarrhoea ✓ ✓ ✓
SDEmergency care · · ✓
SDEpistaxis · · ✓
SDInsomnia ✓ ✓ ✓
SDNausea ✓ ✓ ✓
SDPre-existing disease · · ✓
SDRash · · ✓
SDRhinorrhoea · · ✓
SDSneezing · · ✓
SROInjection site pain · · ✓
SROInsomnia ✓ ✓ ✓
SRONo adverse event ✓ ✓ ✓
SROParaesthesia · · ✓
SRORash · · ✓
SROSelf-medication ✓ ✓ ✓

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

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