2XS-27094-03343

3 vaccinations 8 coded responses 41 check-ins 8 free-text entries 0 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 283 / NC
Registered: 2021-08-11

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

Registered dependents

XXS-13225-06339 Child or adolescent in my care · Female · 2022-01-10

CSF-19514-70501 Child or adolescent in my care · Male · 2022-01-11

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-08-11
Registered in v-safe
2021-08-11
Dose 1 — Moderna
2021-08-11
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-08-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-08-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fever · Headache

Adult check-in
2021-08-14
Survey response — days 1–6 daily, dose 1
MedDRA: Initial insomnia, Insomnia — Feeling: Good · Fever · Headache, Joint pains

Free text: Difficulty falling/staying asleep

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-08-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-08-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-08-18
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-08-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-09-01
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-09-08
Dose 2 — Moderna
2021-09-08
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-09-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-09-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-09-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-09-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-09-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-09-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-09-15
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-09-22
Survey response — day 14, dose 2
MedDRA: Flushing — Feeling: Good

Free text: Flushing of face/cheeks. No fever. Lasted for hours on worst day

MedDRA releases: 2024-11 · check-in free text available
2021-09-29
Survey response — day 21, dose 2
MedDRA: Injection site dryness, Injection site pruritus, Injection site rash, Self-medication — Feeling: Good

Free text: Dry rash on arm just below injection site. Mild itching. Rectangular shape 3 inches long x 1-1.5 inches wide. Has been present following 1st injection. Not responding to lotion or hydrocortisone cream

MedDRA releases: 2024-11 · check-in free text available
2021-10-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-10-13
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-10-20
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-12-08
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-03-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-18
Dose 3 — Moderna
2022-04-18
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · Headache

Adult check-in
2022-04-19
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-20
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches

Adult check-in
2022-04-21
Survey response — days 1–6 daily, dose 3
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good · Site: Pain · Headache

Free text: Swelling and pain in axillary lymph node on side of injection

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Survey response — days 1–6 daily, dose 3
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good · Headache

Free text: Axillary lymph node pain and swelling on side of injection

MedDRA releases: 2024-11 · check-in free text available
2022-04-23
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-04-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-04-25
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-05-02
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-05-09
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-05-16
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-05-23
Survey response — day 35, dose 3
MedDRA: Rash — Feeling: Good

Free text: Rash

MedDRA releases: 2024-11 · check-in free text available
2022-05-30
Survey response — day 42, dose 3
MedDRA: Rash — Feeling: Good

Free text: Rash

MedDRA releases: 2024-11 · check-in free text available
2022-07-18
Survey response — 3 months, dose 3
MedDRA: Pre-existing disease — Feeling: Good

Free text: Rash (chronic)

MedDRA releases: 2024-11 · check-in free text available
2022-10-17
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2023-04-18
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-08-11	Moderna	No
2	2021-09-08	Moderna	No
3	2022-04-18	Moderna	No

Free text

Release 9 — days 1–6 daily, dose 1

2021-08-14

Systemic reaction (other): Difficulty falling/staying asleep

Release 9 — day 14, dose 2

2021-09-22

Symptoms: Flushing of face/cheeks. No fever. Lasted for hours on worst day

Release 9 — day 21, dose 2

2021-09-29

Symptoms: Dry rash on arm just below injection site. Mild itching. Rectangular shape 3 inches long x 1-1.5 inches wide. Has been present following 1st injection. Not responding to lotion or hydrocortisone cream

Release 11 — days 1–6 daily, dose 3

2022-04-21

Systemic reaction (other): Swelling and pain in axillary lymph node on side of injection

2022-04-22

Systemic reaction (other): Axillary lymph node pain and swelling on side of injection

Release 11 — day 35, dose 3

2022-05-23

Symptoms: Rash

Release 11 — day 42, dose 3

2022-05-30

Symptoms: Rash

Release 12 — 3 months, dose 3

2022-07-18

Symptoms: Rash (chronic)

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	Flushing	·	·	✓
SD	Injection site dryness	·	·	✓
SD	Injection site pruritus	·	·	✓
SD	Injection site rash	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Rash	·	·	✓
SD	Self-medication	·	·	✓
SRO	Initial insomnia	✓	·	✓
SRO	Insomnia	✓	·	✓
SRO	Lymph node pain	·	·	✓
SRO	Lymphadenopathy	·	·	✓

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