2H5-20748-77643

3 vaccinations 20 coded responses 38 check-ins 20 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 280 / NC
Registered: 2021-02-04

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-02-04
Registered in v-safe
2021-02-04
Dose 1 — Moderna
2021-02-04
Survey response — day 0, dose 1
MedDRA: Injection site discomfort, Vaccination site pain — Feeling: Good

Free text: A soreness around the area of vaccination

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Pain

Free text: Only soreness at injection area

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-02-09
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Muscle or body aches

Free text: None

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Muscle or body aches

Free text: None

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — day 7, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Joint pains

Free text: I have previously been diagnosed with Rheumatoid Arthritis.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-04
Dose 2 — Moderna
2021-03-04
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Good · Fatigue or tiredness

Free text: A little dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Fair · Fatigue or tiredness

Free text: I feel unusual.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Good · Fatigue or tiredness, Diarrhea

Free text: Pain right side of back

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Good · Headache

Free text: None

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Good · Headache

Free text: Back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-03-18
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-25
Survey response — day 21, dose 2
MedDRA: Headache, Pain in extremity — Feeling: Fair

Free text: Pain from back of knee to below calf in left leg. Pain in top front of right arm. Mild headache.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — day 28, dose 2
MedDRA: Hypoaesthesia — Feeling: Good

Free text: Numbness in both feet

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — day 35, dose 2
MedDRA: Pain, Pain in extremity — Feeling: Good

Free text: Pain in the heel of front right hand.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-05
Survey response — 3 months, dose 2
MedDRA: Pain — Feeling: Fair

Free text: There are small stinging sensations over different ereas of my mid sections of my body. Mainly in the middle front.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-03
Survey response — 6 months, dose 2
MedDRA: Urinary incontinence — Feeling: Good

Free text: I am have urinating leaks

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-28
Dose 3 — Moderna
2021-10-28
Survey response — day 0, dose 3
MedDRA: Musculoskeletal discomfort — Feeling: Good · Site: Pain · Joint pains

Free text: Back discomfort

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-11-01
Survey response — days 1–6 daily, dose 3
MedDRA: Back pain — Feeling: Good · Site: Pain

Free text: Back pain

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-04
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-11
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-25
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-02
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-10
Survey response — day 42, dose 3
MedDRA: Chest discomfort, Musculoskeletal discomfort — Feeling: Fair

Free text: Chess and upper back discomfort.

MedDRA releases: 2024-11 · check-in free text available
2022-01-27
Survey response — 3 months, dose 3
MedDRA: Back pain, Chest pain — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Upper chess and back pains moved down in lower area.

MedDRA releases: 2024-11 · check-in free text available
2022-01-27
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-01-31
Call 1 — Left Voicemail
2022-04-28
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-30
Survey response — 12 months, dose 3
MedDRA: Pain in jaw — Feeling: Good

Free text: Jaw pain. Possibly Lock Jaw.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-04	Moderna
2	2021-03-04	Moderna
3	2021-10-28	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 3 — day 0, dose 1

2021-02-04

Systemic reaction (other): A soreness around the area of vaccination

Release 3 — days 1–6 daily, dose 1

2021-02-05

Systemic reaction (other): Only soreness at injection area

2021-02-09

Systemic reaction (other): None

2021-02-10

Systemic reaction (other): None

Release 4 — day 7, dose 1

2021-02-11

Systemic reaction (other): I have previously been diagnosed with Rheumatoid Arthritis.

Release 5 — day 0, dose 2

2021-03-04

Systemic reaction (other): A little dizzy

Release 5 — days 1–6 daily, dose 2

2021-03-05

Systemic reaction (other): I feel unusual.

2021-03-07

Systemic reaction (other): Pain right side of back

2021-03-08

Systemic reaction (other): None

2021-03-09

Systemic reaction (other): Back pain

Release 6 — day 21, dose 2

2021-03-25

Symptoms: Pain from back of knee to below calf in left leg. Pain in top front of right arm. Mild headache.

Release 6 — day 28, dose 2

2021-04-01

Symptoms: Numbness in both feet

Release 7 — day 35, dose 2

2021-04-08

Symptoms: Pain in the heel of front right hand.

Release 8 — 3 months, dose 2

2021-06-05

Symptoms: There are small stinging sensations over different ereas of my mid sections of my body. Mainly in the middle front.

Release 9 — 6 months, dose 2

2021-09-03

Symptoms: I am have urinating leaks

Release 10 — day 0, dose 3

2021-10-28

Systemic reaction (other): Back discomfort

Release 10 — days 1–6 daily, dose 3

2021-11-01

Systemic reaction (other): Back pain

Release 10 — day 42, dose 3

2021-12-10

Symptoms: Chess and upper back discomfort.

Release 11 — 3 months, dose 3

2022-01-27

Symptoms: Upper chess and back pains moved down in lower area.

Release 12 — 12 months, dose 3

2022-10-30

Symptoms: Jaw pain. Possibly Lock Jaw.

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	Back pain	·	·	✓
SD	Chest discomfort	·	·	✓
SD	Chest pain	·	·	✓
SD	Headache	✓	✓	✓
SD	Hypoaesthesia	✓	✓	✓
SD	Musculoskeletal discomfort	·	·	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Pain in jaw	·	·	✓
SD	Urinary incontinence	✓	·	✓
SRO	Back pain	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Injection site discomfort	○	✓	○
SRO	Injection site pain	✓	✓	✓
SRO	Musculoskeletal discomfort	·	·	✓
SRO	No adverse event	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Vaccination site pain	✓	·	✓

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