2XD-12986-61640

6 vaccinations 13 coded responses 39 check-ins 13 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 024 / MA
Registered: 2021-03-28

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

Timeline

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

2021-03-27
Dose 1 — Moderna
2021-03-28
Registered in v-safe
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · None

Adult check-in
2021-03-30
Survey response — days 1–6 daily, dose 1
MedDRA: Anaphylaxis treatment — Feeling: Fair · Site: Pain, Redness · Fatigue or tiredness

Free text: On doxycycline

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Fatigue or tiredness, Nausea

Free text: On antibiotic- doxycycline

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Fatigue or tiredness

Free text: On antibiotic- doxycycline

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Taking Doxycycline and pre-existing condition

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — day 7, dose 1
MedDRA: Unevaluable event — Feeling: Good

Free text: On doxycycline

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — day 14, dose 1
MedDRA: Axillary pain, Pain in extremity, Peripheral swelling — Feeling: Fair

Free text: Raised painful area on arm of injection w/ some soreness in underarm area

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-24
Dose 2 — Moderna
2021-04-24
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-25
Survey response — days 1–6 daily, dose 2
MedDRA: Arthritis, Pre-existing disease — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: I have Pseudo Arthritis condition

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Self-medication — Feeling: Fair · Site: Pain · Headache, Joint pains

Free text: Took Tylenol on 4/26/2021 to alleviate headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction, Seasonal allergy — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Seasonal allergies symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Survey response — days 1–6 daily, dose 2
MedDRA: Arthritis, Pre-existing disease, Seasonal allergy — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Free text: Pseudo arthritis symptoms and seasonal allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — days 1–6 daily, dose 2
MedDRA: Arthritis, Pre-existing disease — Feeling: Good

Free text: Pseudo arthritis symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-01
Survey response — day 7, dose 2
MedDRA: Pre-existing disease — Feeling: Good

Free text: Seasonal allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-29
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-05
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-24
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-03
Dose 3 — Moderna
2021-10-23
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-03
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-02-03
Dose 4 — Moderna
2022-03-04
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-03-04
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-03-10
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-03-17
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-04-24
Dose 5 — Moderna
2022-05-05
Survey response — 3 months, dose 4
MedDRA: Office visit, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Pemphigus detected - pre-existing condition · Healthcare visit (other): Seen in person

MedDRA releases: 2024-11 · check-in free text available
2022-05-05
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-06
Call 1 — Could Not Reach Participant
2022-05-11
Call successful
Not applicable - Accidental Reporting
2022-08-04
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2022-09-30
Dose 6 — Moderna
2022-10-09
Health check-in — day 7, dose 6
Feeling: Fair · Site: Swelling · None

Adult check-in
2022-10-14
Health check-in — day 14, dose 6
Feeling: Good

Adult check-in
2022-10-21
Health check-in — day 21, dose 6
Feeling: Good

Adult check-in
2022-10-28
Health check-in — day 28, dose 6
Feeling: Fair

Adult check-in
2022-11-04
Health check-in — day 35, dose 6
Feeling: Good

Adult check-in
2022-11-11
Health check-in — day 42, dose 6
Feeling: Good

Adult check-in
2022-12-30
Health check-in — 3 months, dose 6
Feeling: Good

Adult check-in
2023-03-31
Health check-in — 6 months, dose 6
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-27	Moderna
2	2021-04-24	Moderna
3	2021-09-03	Moderna	No
4	2022-02-03	Moderna	No
5	2022-04-24	Moderna	No
6	2022-09-30	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-30

Systemic reaction (other): On doxycycline

2021-03-31

Systemic reaction (other): On antibiotic- doxycycline

2021-04-01

Systemic reaction (other): On antibiotic- doxycycline

2021-04-02

Systemic reaction (other): Taking Doxycycline and pre-existing condition

Release 6 — day 7, dose 1

2021-04-03

Systemic reaction (other): On doxycycline

Release 7 — day 14, dose 1

2021-04-10

Symptoms: Raised painful area on arm of injection w/ some soreness in underarm area

Release 7 — days 1–6 daily, dose 2

2021-04-25

Systemic reaction (other): I have Pseudo Arthritis condition

Release 8 — days 1–6 daily, dose 2

2021-04-26

Systemic reaction (other): Took Tylenol on 4/26/2021 to alleviate headache

2021-04-27

Systemic reaction (other): Seasonal allergies symptoms

2021-04-28

Systemic reaction (other): Pseudo arthritis symptoms and seasonal allergies

2021-04-29

Systemic reaction (other): Pseudo arthritis symptoms

Release 8 — day 7, dose 2

2021-05-01

Systemic reaction (other): Seasonal allergies

Release 11 — 3 months, dose 4

2022-05-05

Symptoms: Pemphigus detected - pre-existing condition

Healthcare visit (other): Seen in person

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	Axillary pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SRO	Adverse reaction	·	·	✓
SRO	Anaphylaxis treatment	✓	✓	✓
SRO	Arthritis	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Seasonal allergy	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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