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39J-31127-05714

5 vaccinations 6 coded responses 33 check-ins 6 free-text entries 1 call case
Sex
Female
Age at first dose
61-65
ZIP prefix
940 / CA
Registered
2021-11-17
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-01
    Dose 1 — Moderna
  2. 2021-03-01
    Dose 2 — Moderna
  3. 2021-11-17
    Registered in v-safe
  4. 2021-11-17
    Dose 3 — Moderna
  5. 2021-11-17
    Health check-in — day 0, dose 3
    Feeling: Fair · Site: Redness, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  6. 2021-11-18
    Survey response — days 1–6 daily, dose 3
    MedDRA: Adverse reaction, Pre-existing disease, Vaccine positive rechallenge — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: I am a lupus patient. My 2nd Moderna shot took me out for a full day following the shot. I expected a similar reaction with my booster, but am surprised it's basically the same as shot #2.
    MedDRA releases: 2024-11 · check-in free text available
  7. 2021-11-19
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  8. 2021-11-20
    Survey response — days 1–6 daily, dose 3
    MedDRA: Pre-existing disease — Feeling: Good · Headache, Joint pains, Muscle or body aches
    Free text: I am a Lupus patient, so I expect my return to "normal" to be a bit longer.
    MedDRA releases: 2024-11 · check-in free text available
  9. 2021-11-21
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  10. 2021-11-22
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  11. 2021-11-23
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  12. 2021-11-24
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  13. 2021-12-01
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  14. 2021-12-08
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  15. 2021-12-15
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  16. 2021-12-22
    Health check-in — day 35, dose 3
    Feeling: Fair
    Adult check-in
  17. 2021-12-29
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  18. 2022-02-16
    Survey response — 3 months, dose 3
    MedDRA: Bronchitis, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Called that descended into bronchitis, which I had for approximately six weeks and was treated by a doctor with antibiotics. no other symptoms appeared that would have put me into the "possibly Covid" category.
    MedDRA releases: 2024-11 · check-in free text available
  19. 2022-02-16
    Report sent to call center — 3 months, dose 3
    Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · 1 call case(s)
  20. 2022-02-21
  21. 2022-02-21
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  22. 2022-04-08
    Dose 4 — Moderna
  23. 2022-04-15
    Health check-in — day 7, dose 4
    Feeling: Good · None
    Adult check-in
  24. 2022-04-23
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  25. 2022-05-01
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  26. 2022-05-08
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  27. 2022-05-13
    Health check-in — day 35, dose 4
    Feeling: Fair
    Adult check-in
  28. 2022-05-22
    Health check-in — day 42, dose 4
    Feeling: Fair
    Adult check-in
  29. 2022-07-08
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  30. 2022-10-03
    Dose 5 — Moderna
  31. 2022-10-07
    Health check-in — days 1–6 daily, dose 5
    Feeling: Good · Site: Itching · Headache, Muscle or body aches
    Adult check-in
  32. 2022-10-07
    Survey response — 6 months, dose 4
    MedDRA: Bronchitis — Feeling: Good
    Free text: Bronchitis
    MedDRA releases: 2024-11 · check-in free text available
  33. 2022-10-08
    Health check-in — days 1–6 daily, dose 5
    Feeling: Good · None
    Adult check-in
  34. 2022-10-09
    Survey response — days 1–6 daily, dose 5
    MedDRA: Systemic lupus erythematosus — Feeling: Fair · Muscle or body aches, Fatigue or tiredness
    Free text: SLE patient
    MedDRA releases: 2024-11 · check-in free text available
  35. 2022-10-10
    Survey response — day 7, dose 5
    MedDRA: Pre-existing disease — Feeling: Fair · Headache, Fatigue or tiredness
    Free text: Lupus patient
    MedDRA releases: 2024-11 · check-in free text available
  36. 2022-10-17
    Health check-in — day 14, dose 5
    Feeling: Fair
    Adult check-in
  37. 2022-10-24
    Health check-in — day 21, dose 5
    Feeling: Fair
    Adult check-in
  38. 2022-10-31
    Health check-in — day 28, dose 5
    Feeling: Fair
    Adult check-in
  39. 2022-11-07
    Health check-in — day 35, dose 5
    Feeling: Fair
    Adult check-in
  40. 2022-11-14
    Health check-in — day 42, dose 5
    Feeling: Good
    Adult check-in
  41. 2023-01-02
    Health check-in — 3 months, dose 5
    Feeling: Good
    Adult check-in
  42. 2023-04-03
    Health check-in — 6 months, dose 5
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-01Moderna No
22021-03-01Moderna No
32021-11-17Moderna No
42022-04-08Moderna No
52022-10-03Moderna No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 10 — days 1–6 daily, dose 3

2021-11-18

Systemic reaction (other): I am a lupus patient. My 2nd Moderna shot took me out for a full day following the shot. I expected a similar reaction with my booster, but am surprised it's basically the same as shot #2.

2021-11-20

Systemic reaction (other): I am a Lupus patient, so I expect my return to "normal" to be a bit longer.

Release 11 — 3 months, dose 3

2022-02-16

Symptoms: Called that descended into bronchitis, which I had for approximately six weeks and was treated by a doctor with antibiotics. no other symptoms appeared that would have put me into the "possibly Covid" category.

Release 12 — 6 months, dose 4

2022-10-07

Symptoms: Bronchitis

Release 12 — days 1–6 daily, dose 5

2022-10-09

Systemic reaction (other): SLE patient

Release 12 — day 7, dose 5

2022-10-10

Systemic reaction (other): Lupus patient

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

FieldPreferred term2021-092023-042024-11
SDBronchitis · · ✓
SDOffice visit · · ✓
SROAdverse reaction · · ✓
SROPre-existing disease · · ✓
SROSystemic lupus erythematosus · · ✓
SROVaccine positive rechallenge · · ✓

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

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