2FL-19469-64878

4 vaccinations 5 coded responses 16 check-ins 5 free-text entries 4 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 531 / WI
Registered: 2021-03-17

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

2021-03-09
Dose 1 — Moderna
2021-03-17
Registered in v-safe
2021-03-17
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-30
Survey response — day 21, dose 1
MedDRA: Injection site inflammation, Injection site pain, Injection site rash, Office visit, Rash pruritic, Vaccination site reaction — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Delayed serum reaction at injection site. Spread as a painful itchy rash up the shoulder and down to the elbow. Had to be evaluated at urgi care. Dr advised to get the second dose in opposite arm. Was given steroid cream to get inflammation down.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-04
Dose 2 — Moderna
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Redness · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Rash — Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Mild rash across cheeks and nose

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: Itching · Fever · Chills, 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: Itching · Fatigue or tiredness

Adult check-in
2021-04-19
Survey response — day 14, dose 2
MedDRA: Arthralgia, Bone pain, Chills, Cough, Diarrhoea, Dyspnoea, Fatigue, Medical counselling, Oropharyngeal pain, Pain, Pyrexia, SARS-CoV-2 test, Wheezing — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Since Tuesday /Wednesday FeverCough deep painful. Sore throat, Shortness of breath.Body aches-bones felt crushed.Chills.Joint pain-like had shards of glass in them. Diarrhea.Fatigue.wheezing.Got a PCR Covid test yesterday....waiting on results · Healthcare visit (other): My nurse told me she believes I have Covid-to go get tested. Yesterday, i went to Drive thru pharmacy PCR covid test. IF negative I will Go in to urgicare to get something for bronchial crap

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Report sent to call center — day 14, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-16
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-04
Survey response — 3 months, dose 2
MedDRA: Kidney infection — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Kidney infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-04
Report sent to call center — 3 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

1 call case(s)
2021-07-08
Call 1 — Left Voicemail
2021-08-17
Dose 3 — Moderna
Co-administered: Flu
2021-10-03
Survey response — 6 months, dose 2
MedDRA: Cough, Sinusitis, Upper respiratory tract infection — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sinus infection/upper respiratory/cough

MedDRA releases: 2024-11 · check-in free text available
2021-10-03
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-06
Call 1 — Left Voicemail
2022-02-12
Dose 4 — Moderna
2022-04-05
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in
2022-05-14
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-08-15
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in
2023-02-12
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-09	Moderna
2	2021-04-04	Moderna
3	2021-08-17	Moderna	Flu
4	2022-02-12	Moderna	No

Call center

4 call center cases

4 unsuccessful

See the call center timeline

Free text

Release 6 — day 21, dose 1

2021-03-30

Symptoms: Delayed serum reaction at injection site. Spread as a painful itchy rash up the shoulder and down to the elbow. Had to be evaluated at urgi care. Dr advised to get the second dose in opposite arm. Was given steroid cream to get inflammation down.

Release 7 — days 1–6 daily, dose 2

2021-04-08

Systemic reaction (other): Mild rash across cheeks and nose

Release 7 — day 14, dose 2

2021-04-19

Symptoms: Since Tuesday /Wednesday FeverCough deep painful. Sore throat, Shortness of breath.Body aches-bones felt crushed.Chills.Joint pain-like had shards of glass in them. Diarrhea.Fatigue.wheezing.Got a PCR Covid test yesterday....waiting on results

Healthcare visit (other): My nurse told me she believes I have Covid-to go get tested. Yesterday, i went to Drive thru pharmacy PCR covid test. IF negative I will Go in to urgicare to get something for bronchial crap

Release 9 — 3 months, dose 2

2021-07-04

Symptoms: Kidney infection

Release 9 — 6 months, dose 2

2021-10-03

Symptoms: Sinus infection/upper respiratory/cough

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	Medical counselling	✓	✓	✓
HCVO	SARS-CoV-2 test	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Bone pain	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Injection site inflammation	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Kidney infection	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SD	SARS-CoV-2 test	✓	✓	✓
SD	Sinusitis	·	·	✓
SD	Upper respiratory tract infection	·	·	✓
SD	Vaccination site reaction	✓	✓	✓
SD	Wheezing	✓	✓	✓
SRO	Rash	✓	✓	✓

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