3NX-25834-70906

2 vaccinations 13 coded responses 24 check-ins 13 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 131 / NY
Registered: 2021-09-15

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

Timeline

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

2021-09-15
Registered in v-safe
2021-09-15
Dose 1 — Moderna
2021-09-15
Survey response — day 0, dose 1
MedDRA: Presyncope — Feeling: Fair · Nausea

Free text: I felt like I was going to pass out

MedDRA releases: 2024-11 · check-in free text available
2021-09-16
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Good · Site: Pain · Joint pains, Nausea

Free text: Last night pain in calf and in upper thigh

MedDRA releases: 2024-11 · check-in free text available
2021-09-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-09-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-09-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-09-20
Survey response — days 1–6 daily, dose 1
MedDRA: Glossodynia, Influenza like illness, Oropharyngeal pain — Feeling: Fair · Fatigue or tiredness

Free text: Sore throat, sore tongue, felt flu like.

MedDRA releases: 2024-11 · check-in free text available
2021-09-21
Survey response — days 1–6 daily, dose 1
MedDRA: Increased upper airway secretion — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lots of phlegm in my throat.

MedDRA releases: 2024-11 · check-in free text available
2021-09-22
Survey response — day 7, dose 1
MedDRA: Glossodynia — Feeling: Fair · Joint pains, Fatigue or tiredness

Free text: Sore tongue

MedDRA releases: 2024-11 · check-in free text available
2021-09-29
Survey response — day 14, dose 1
MedDRA: Fatigue, Injection site erythema, Mobility decreased, Urticaria — Feeling: Fair · Be unable to do your normal daily activities

Free text: Red arm where I received the vaccine, hives on my leg on the same side I received vaccine. Exhausted. Unable to lift my arm.

MedDRA releases: 2024-11 · check-in free text available
2021-10-06
Survey response — day 21, dose 1
MedDRA: Adverse reaction, Medical counselling, Urticaria — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: New hives on my other thigh, chest, and back. · Healthcare visit (other): I phoned my Dr to talk to her about my symptoms. And my upcoming next vaccine.

MedDRA releases: 2024-11 · check-in free text available
2021-10-06
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-13
Dose 2 — Moderna
2021-10-13
Survey response — day 0, dose 2
MedDRA: Unevaluable event — Feeling: Good

Free text: I have literally just received the shot not 15 minutes ago

MedDRA releases: 2024-11 · check-in free text available
2021-10-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-15
Survey response — days 1–6 daily, dose 2
MedDRA: Body temperature increased, Decreased appetite, Nausea, Pyrexia — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Late last night my temp kept going up, early this am middle of the night it got to 102.8. Then around 5:30 am it started to go down. And this am it was normal . Last evening I had nausea so bad that I couldn't eat. But that wasn't today.

MedDRA releases: 2024-11 · check-in free text available
2021-10-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-10-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains

Adult check-in
2021-10-20
Survey response — day 7, dose 2
MedDRA: Urticaria — Feeling: Poor · Joint pains, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Hives

MedDRA releases: 2024-11 · check-in free text available
2021-10-27
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-11-03
Survey response — day 21, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good

Free text: Sore throat

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

Adult check-in
2021-11-17
Survey response — day 35, dose 2
MedDRA: Increased upper airway secretion, Musculoskeletal stiffness, Oropharyngeal pain, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Lots of phlegm in my throat, sore throat, off and on, stiff neck. · Healthcare visit (other): I called and am going to to see the Dr in AM

MedDRA releases: 2024-11 · check-in free text available
2021-11-17
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-18
Call 1 — Left Voicemail
2021-11-25
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2022-01-12
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-10-13
Survey response — 12 months, dose 2
MedDRA: Limb discomfort, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Heaviness in my arms · Healthcare visit (other): Seen by primary care Dr

MedDRA releases: 2024-11 · check-in free text available
2022-10-13
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-14
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-14
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-14
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-09-15	Moderna	No
2	2021-10-13	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 9 — day 0, dose 1

2021-09-15

Systemic reaction (other): I felt like I was going to pass out

Release 9 — days 1–6 daily, dose 1

2021-09-16

Systemic reaction (other): Last night pain in calf and in upper thigh

2021-09-20

Systemic reaction (other): Sore throat, sore tongue, felt flu like.

2021-09-21

Systemic reaction (other): Lots of phlegm in my throat.

Release 9 — day 7, dose 1

2021-09-22

Systemic reaction (other): Sore tongue

Release 9 — day 14, dose 1

2021-09-29

Symptoms: Red arm where I received the vaccine, hives on my leg on the same side I received vaccine. Exhausted. Unable to lift my arm.

Release 10 — day 21, dose 1

2021-10-06

Symptoms: New hives on my other thigh, chest, and back.

Healthcare visit (other): I phoned my Dr to talk to her about my symptoms. And my upcoming next vaccine.

Release 10 — day 0, dose 2

2021-10-13

Systemic reaction (other): I have literally just received the shot not 15 minutes ago

Release 10 — days 1–6 daily, dose 2

2021-10-15

Systemic reaction (other): Late last night my temp kept going up, early this am middle of the night it got to 102.8. Then around 5:30 am it started to go down. And this am it was normal . Last evening I had nausea so bad that I couldn't eat. But that wasn't today.

Release 10 — day 7, dose 2

2021-10-20

Systemic reaction (other): Hives

Release 10 — day 21, dose 2

2021-11-03

Symptoms: Sore throat

Release 10 — day 35, dose 2

2021-11-17

Symptoms: Lots of phlegm in my throat, sore throat, off and on, stiff neck.

Healthcare visit (other): I called and am going to to see the Dr in AM

Release 12 — 12 months, dose 2

2022-10-13

Symptoms: Heaviness in my arms

Healthcare visit (other): Seen by primary care Dr

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	Adverse reaction	·	·	✓
HCVO	Medical counselling	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Fatigue	·	·	✓
SD	Increased upper airway secretion	·	·	✓
SD	Injection site erythema	·	·	✓
SD	Limb discomfort	·	·	✓
SD	Mobility decreased	·	·	✓
SD	Musculoskeletal stiffness	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Urticaria	·	·	✓
SRO	Body temperature increased	·	·	✓
SRO	Decreased appetite	·	·	✓
SRO	Glossodynia	·	·	✓
SRO	Increased upper airway secretion	·	·	✓
SRO	Influenza like illness	·	·	✓
SRO	Nausea	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Pain in extremity	·	·	✓
SRO	Presyncope	·	·	✓
SRO	Pyrexia	·	·	✓
SRO	Unevaluable event	·	·	✓
SRO	Urticaria	·	·	✓

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