3AN-56197-19077

3 vaccinations 14 coded responses 20 check-ins 14 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 387 / MS
Registered: 2021-03-24

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

2021-03-23
Dose 1 — Moderna
2021-03-24
Registered in v-safe
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-25
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Pre-existing disease — Feeling: Good · Fatigue or tiredness

Free text: I think my tiredness is from my Lupus/Pulmonary Fibrosis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Site: Pain, Itching · Joint pains, Muscle or body aches

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-01
Survey response — day 7, dose 1
MedDRA: Office visit, Rash — Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Rash in the inner thigh areas of both legs. · Healthcare visit (other): Lupus Dr and will be seeing the dermatologists on April 1, 2021 @ 2: 00 pm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

no matching call case
2021-04-06
Survey response — day 14, dose 1
MedDRA: Asthenia, Dizziness — Feeling: Fair

Free text: Weak and lightheaded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — day 21, dose 1
MedDRA: Asthenia, Burning sensation, Dizziness — Feeling: Fair · Be unable to do your normal daily activities

Free text: Constantly feeling weak, and feeling like im burning in my thoracic area, feeling light headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Dose 2 — Moderna
2021-04-25
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Induration, Nodule, Pain, Pruritus — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Itchy firery pain, hard red knot in arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Itching · None

Adult check-in
2021-04-27
Survey response — day 7, dose 2
MedDRA: Feeling hot — Feeling: Good · Site: Redness, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Hot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Survey response — day 14, dose 2
MedDRA: Dyspnoea, Fatigue, Spinal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Very tired and painin my thoracic area along with lots of shortness of breath.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Survey response — day 21, dose 2
MedDRA: Abdominal discomfort, Burning sensation, Neck pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Severe burning pain in my neck, back and chest in the thoracic area.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Survey response — day 28, dose 2
MedDRA: Back pain, Burning sensation, Chest pain, Dyspepsia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Severe pain and burning in my back , stomach, and chest.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-25
Survey response — day 35, dose 2
MedDRA: Back pain, Burning sensation, Dyspnoea exertional — Feeling: Poor · Be unable to do your normal daily activities

Free text: Constantly having severe shortage of breath with exertion and pain with severe burning in the center of my back in between my shoulders.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Survey response — day 42, dose 2
MedDRA: Dyspnoea, Spinal pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Shortness of breath and serious pain in my thoracic area. The center of my back between my shoulder blades.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-20
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-19
Survey response — 6 months, dose 2
MedDRA: Chest pain, Cough, Dyspepsia, Headache, Nasal congestion, Office visit, Productive cough, Rhinorrhoea — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Headaches, stuffy running nose, burning in chest and stomach, persistent cough with phlegm. · Healthcare visit (other): Went to see all three, pulmonary docs, lupus docs, and GI docs.

MedDRA releases: 2024-11 · check-in free text available
2021-10-19
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-25
Call 1 — Could Not Reach Participant
2021-10-28
Call 2 — Could Not Reach Participant
2021-11-10
Dose 3 — Moderna
2022-04-20
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-11
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-11
Survey response — 12 months, dose 3
MedDRA: Pain in extremity, Peripheral swelling — Feeling: Good · Be unable to do your normal daily activities

Free text: Lower right leg pain and swelling

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-23	Moderna
2	2021-04-20	Moderna
3	2021-11-10	Moderna	No

Call center

1 call center case

1 unsuccessful

1 check-in flagged for a call with no call center case on record

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-25

Systemic reaction (other): I think my tiredness is from my Lupus/Pulmonary Fibrosis

2021-03-28

Systemic reaction (other): No

Release 6 — day 7, dose 1

2021-04-01

Systemic reaction (other): Rash in the inner thigh areas of both legs.

Healthcare visit (other): Lupus Dr and will be seeing the dermatologists on April 1, 2021 @ 2: 00 pm

Release 7 — day 14, dose 1

2021-04-06

Symptoms: Weak and lightheaded

Release 7 — day 21, dose 1

2021-04-13

Symptoms: Constantly feeling weak, and feeling like im burning in my thoracic area, feeling light headed

Release 7 — days 1–6 daily, dose 2

2021-04-25

Systemic reaction (other): Itchy firery pain, hard red knot in arm.

Release 8 — day 7, dose 2

2021-04-27

Systemic reaction (other): Hot

Release 8 — day 14, dose 2

2021-05-04

Symptoms: Very tired and painin my thoracic area along with lots of shortness of breath.

Release 8 — day 21, dose 2

2021-05-11

Symptoms: Severe burning pain in my neck, back and chest in the thoracic area.

Release 8 — day 28, dose 2

2021-05-18

Symptoms: Severe pain and burning in my back , stomach, and chest.

Release 8 — day 35, dose 2

2021-05-25

Symptoms: Constantly having severe shortage of breath with exertion and pain with severe burning in the center of my back in between my shoulders.

Release 8 — day 42, dose 2

2021-06-01

Symptoms: Shortness of breath and serious pain in my thoracic area. The center of my back between my shoulder blades.

Release 10 — 6 months, dose 2

2021-10-19

Symptoms: Headaches, stuffy running nose, burning in chest and stomach, persistent cough with phlegm.

Healthcare visit (other): Went to see all three, pulmonary docs, lupus docs, and GI docs.

Release 12 — 12 months, dose 3

2022-11-11

Symptoms: Lower right leg pain and swelling

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	Back pain	✓	✓	✓
SD	Burning sensation	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Cough	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Dyspepsia	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Dyspnoea exertional	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Neck pain	✓	✓	✓
SD	Pain in extremity	·	·	✓
SD	Peripheral swelling	·	·	✓
SD	Productive cough	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Spinal pain	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling hot	✓	✓	✓
SRO	Induration	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Nodule	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Rash	✓	✓	✓

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