2CC-27851-60562

2 vaccinations 8 coded responses 24 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 334 / FL
Registered: 2021-03-10

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

Timeline

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

2021-03-10
Registered in v-safe
2021-03-10
Dose 1 — Moderna
2021-03-10
Survey response — day 0, dose 1
MedDRA: Arthralgia, Pain in extremity — Feeling: Good · Site: Pain · Muscle or body aches · Be unable to work, Be unable to do your normal daily activities

Free text: Upper arm, shoulder aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-17
Survey response — day 7, dose 1
MedDRA: Pain of skin — Feeling: Good · Headache

Free text: Scalp hurts

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — day 14, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

Free text: In lupus flare - according to labwork done 3/18. High see rate etc . I truly think the first shot caused it but its okay, I understand!! Better than the alternative...

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-07
Dose 2 — Moderna
2021-04-07
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches

Free text: Dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Respiratory tract congestion — Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Congestion,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Diarrhea

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-14
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-28
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-14
Survey response — day 35, dose 2
MedDRA: Headache — Feeling: Good · Be unable to do your normal daily activities

Free text: Terrible headaches. Last week and this week. 4-5 times.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-10
Survey response — 3 months, dose 2
MedDRA: Chest pain, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Symptoms: Breathing issues. Chest pain. · Healthcare visit (other): CT scan, echo, pft outpatient - pulmonologist visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-10
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-19
Call 1 — Left Voicemail
2022-04-09
Survey response — 12 months, dose 2
MedDRA: Alopecia, Colitis, Gastrointestinal haemorrhage, Pre-existing disease, Sjogren's syndrome, Systemic lupus erythematosus — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Had GI bleed & severe acute colitis, lupus flare continuous and severe sjogrens symptoms , also severe hair loss

MedDRA releases: 2024-11 · check-in free text available
2022-04-09
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-04-13
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-10	Moderna
2	2021-04-07	Moderna

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 5 — day 0, dose 1

2021-03-10

Systemic reaction (other): Upper arm, shoulder aches

Release 5 — day 7, dose 1

2021-03-17

Systemic reaction (other): Scalp hurts

Release 6 — day 14, dose 1

2021-03-24

Symptoms: In lupus flare - according to labwork done 3/18. High see rate etc . I truly think the first shot caused it but its okay, I understand!! Better than the alternative...

Release 7 — day 0, dose 2

2021-04-07

Systemic reaction (other): Dizzy

Release 7 — days 1–6 daily, dose 2

2021-04-08

Systemic reaction (other): Congestion,

Release 8 — day 35, dose 2

2021-05-14

Symptoms: Terrible headaches. Last week and this week. 4-5 times.

Release 9 — 3 months, dose 2

2021-07-10

Symptoms: Breathing issues. Chest pain.

Healthcare visit (other): CT scan, echo, pft outpatient - pulmonologist visit

Release 11 — 12 months, dose 2

2022-04-09

Symptoms: Had GI bleed & severe acute colitis, lupus flare continuous and severe sjogrens symptoms , also severe hair loss

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
HCVO	Office visit	✓	✓	✓
SD	Alopecia	·	·	✓
SD	Chest pain	✓	✓	✓
SD	Colitis	·	·	✓
SD	Gastrointestinal haemorrhage	·	·	✓
SD	Headache	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Sjogren's syndrome	·	·	✓
SD	Systemic lupus erythematosus	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pain of skin	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓

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