2KA-12061-90711

2 vaccinations 6 coded responses 23 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 283 / NC
Registered: 2021-03-19

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

2021-03-19
Registered in v-safe
2021-03-19
Dose 1 — Moderna
2021-03-19
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-02
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site induration, Injection site nodule, Injection site pain, Injection site pruritus — Feeling: Fair

Free text: On yesterday the site of injection developed a big hard knot, it started burning and itching, as well as the site being red and swollen.

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

Adult check-in
2021-04-13
Dose 2 — Moderna
2021-04-13
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Headache, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Chills, Headache, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-22
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-05
Survey response — day 21, dose 2
MedDRA: Headache — Feeling: Fair

Free text: I've just been having having more frequent headaches since the last injection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Survey response — day 28, dose 2
MedDRA: Erythema, Induration, Peripheral swelling, Pruritus, Rash, Skin irritation, Skin warm — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Hard, hot bumps on my arms. The areas itches very bad, are red, and swollen. Clothing or covering irritates the area causing it to itch more.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-18
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-13
Survey response — 3 months, dose 2
MedDRA: Abdominal discomfort — Feeling: Good

Free text: Upset stomach

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-15
Survey response — 6 months, dose 2
MedDRA: Chest discomfort, Chest pain, Cough, Headache, Paranasal sinus discomfort, Respiratory tract congestion, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Extreme sinus pressure; sharp pain shooting to the top of my head; runny nose; headache; pain in upper chest; heaviness in chest; hard coughing; congestion

MedDRA releases: 2024-11 · check-in free text available
2021-10-15
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
2021-10-19
Call 1 — Left Voicemail
2022-04-13
Survey response — 12 months, dose 2
MedDRA: Asthenia, Chills, Dyspnoea, Office visit, Pain, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Sinus, aching, chills, weakness, shortness of breath · Healthcare visit (other): Doctor appointment

MedDRA releases: 2024-11 · check-in free text available
2022-04-13
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-14
Call successful
Not applicable - Accidental Reporting

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-19	Moderna
2	2021-04-13	Moderna

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 6 — day 14, dose 1

2021-04-02

Symptoms: On yesterday the site of injection developed a big hard knot, it started burning and itching, as well as the site being red and swollen.

Release 8 — day 21, dose 2

2021-05-05

Symptoms: I've just been having having more frequent headaches since the last injection.

Release 8 — day 28, dose 2

2021-05-11

Symptoms: Hard, hot bumps on my arms. The areas itches very bad, are red, and swollen. Clothing or covering irritates the area causing it to itch more.

Release 9 — 3 months, dose 2

2021-07-13

Symptoms: Upset stomach

Release 10 — 6 months, dose 2

2021-10-15

Symptoms: Extreme sinus pressure; sharp pain shooting to the top of my head; runny nose; headache; pain in upper chest; heaviness in chest; hard coughing; congestion

Release 11 — 12 months, dose 2

2022-04-13

Symptoms: Sinus, aching, chills, weakness, shortness of breath

Healthcare visit (other): Doctor appointment

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	Abdominal discomfort	✓	✓	✓
SD	Asthenia	·	·	✓
SD	Chest discomfort	·	·	✓
SD	Chest pain	·	·	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Erythema	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Induration	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site induration	✓	✓	✓
SD	Injection site nodule	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Pain	·	·	✓
SD	Paranasal sinus discomfort	·	·	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Skin irritation	✓	✓	✓
SD	Skin warm	✓	✓	✓
SD	Unevaluable event	·	·	✓

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