3MD-30304-91844

4 vaccinations 8 coded responses 16 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 207 / MD
Registered: 2021-03-29

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

2021-03-01
Dose 1 — Moderna
2021-03-29
Registered in v-safe
2021-03-29
Dose 2 — Moderna
2021-03-29
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Chills

Adult check-in
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Headache, Pain, Swelling — Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: On Monday I had chills and shivering I couldnt control.Tuesdayand Wednesday just pain and swelling. Im it today because I was hard to reach this week. I also had headache yesterday but not today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Good · Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Chills, Fatigue or tiredness

Adult check-in
2021-04-05
Health check-in — day 7, dose 2
Feeling: Good · Headache

Adult check-in
2021-04-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-21
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-26
Health check-in — day 28, dose 2
Feeling: Good

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

Adult check-in
2021-05-10
Survey response — day 42, dose 2
MedDRA: Chills, Night sweats — Feeling: Fair

Free text: Night sweats, chills,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-28
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-27
Dose 3 — Moderna
2021-09-27
Survey response — 6 months, dose 2
MedDRA: Blister, Erythema, Joint swelling, Skin discolouration — Feeling: Good

Free text: With the booster, I had swelling in my ankles and the booster attacked the swelling with red patches and blistering where the swelling was in my ankles. It has left dark patches that have not cleared up yet.

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Survey response — 3 months, dose 3
MedDRA: Fluid retention — Feeling: Fair

Free text: Trapped fluid in my left leg.

MedDRA releases: 2024-11 · check-in free text available
2022-02-25
Survey response — 6 months, dose 3
MedDRA: Pain, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Significant increase in pain due to arthritis or sickle cell disease.

MedDRA releases: 2024-11 · check-in free text available
2022-02-25
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-07
Call 1 — Could Not Reach Participant
2022-03-10
Call 2 — Could Not Reach Participant
2022-10-29
Dose 4 — Moderna
2023-01-30
Survey response — 3 months, dose 4
MedDRA: Condition aggravated, Flank pain, Pre-existing disease — 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, Hospitalization

MedDRA releases: 2024-11
2023-01-30
Report sent to call center — 3 months, dose 4
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 · Hospitalization · 1 call case(s)
2023-01-31
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-01-31
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-05-01
Survey response — 6 months, dose 4
MedDRA: Mobility decreased, Pain — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-01	Moderna
2	2021-03-29	Moderna
3	2021-08-27	Moderna	No
4	2022-10-29	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 2

2021-04-01

Systemic reaction (other): On Monday I had chills and shivering I couldnt control.Tuesdayand Wednesday just pain and swelling. Im it today because I was hard to reach this week. I also had headache yesterday but not today.

2021-04-02

Systemic reaction (other): No

Release 8 — day 42, dose 2

2021-05-10

Symptoms: Night sweats, chills,

Release 9 — 6 months, dose 2

2021-09-27

Symptoms: With the booster, I had swelling in my ankles and the booster attacked the swelling with red patches and blistering where the swelling was in my ankles. It has left dark patches that have not cleared up yet.

Release 10 — 3 months, dose 3

2021-11-26

Symptoms: Trapped fluid in my left leg.

Release 11 — 6 months, dose 3

2022-02-25

Symptoms: Significant increase in pain due to arthritis or sickle cell disease.

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	Blister	·	·	✓
SD	Chills	✓	✓	✓
SD	Condition aggravated	·	·	✓
SD	Erythema	·	·	✓
SD	Flank pain	·	·	✓
SD	Fluid retention	·	·	✓
SD	Joint swelling	·	·	✓
SD	Mobility decreased	·	·	✓
SD	Night sweats	✓	✓	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Skin discolouration	·	·	✓
SRO	Chills	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Swelling	✓	✓	✓

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