3R2-29280-12122

3 vaccinations 6 coded responses 27 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 068 / CT
Registered: 2020-12-30

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

2020-12-29
Dose 1 — Moderna
2020-12-30
Registered in v-safe
2020-12-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-01
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Good · Site: Pain, Itching · Fatigue or tiredness

Free text: Minimal tiredness and suspect unrelated to shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Itching · None

Adult check-in
2021-01-04
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain, Injection site pruritus — Feeling: Good · Site: Itching

Free text: Injection site is still tender to palpation and has been more itchy the last 1-2 days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-06
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-26
Dose 2 — Moderna
2021-01-26
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-27
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Nasopharyngitis — Feeling: Poor · Site: Pain, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Not shaking chills but during the night I was really cold and teeth were chattering

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Itching · Fatigue or tiredness

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-01
Survey response — days 1–6 daily, dose 2
MedDRA: Flushing, Hyperhidrosis — Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness

Free text: Felt flushed and sweaty at times

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Health check-in — day 7, dose 2
Feeling: Fair · Site: Itching · Fatigue or tiredness

Adult check-in
2021-02-09
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-02-16
Survey response — day 21, dose 2
MedDRA: Arthralgia, Bursitis, Rotator cuff syndrome, Tendonitis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Shoulder pain. Right subacromial bursitis, impingement syndrome, biceps tendinitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-07-27
Survey response — 6 months, dose 2
MedDRA: Condition aggravated, Ear infection, Medical counselling, Pre-existing disease — Feeling: Good · 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: Symptoms: Herniated disc L1-2 flare up in June. Ear infection earlier this month · Healthcare visit (other): Phone call

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-27
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-03
Call 1 — Left Voicemail
2021-11-18
Dose 3 — Moderna
2022-01-28
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-02-17
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-11-18
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-29	Moderna
2	2021-01-26	Moderna
3	2021-11-18	Moderna	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-01

Systemic reaction (other): Minimal tiredness and suspect unrelated to shot.

2021-01-04

Systemic reaction (other): Injection site is still tender to palpation and has been more itchy the last 1-2 days.

Release 2 — days 1–6 daily, dose 2

2021-01-27

Systemic reaction (other): Not shaking chills but during the night I was really cold and teeth were chattering

Release 3 — days 1–6 daily, dose 2

2021-02-01

Systemic reaction (other): Felt flushed and sweaty at times

Release 4 — day 21, dose 2

2021-02-16

Symptoms: Shoulder pain. Right subacromial bursitis, impingement syndrome, biceps tendinitis

Release 9 — 6 months, dose 2

2021-07-27

Symptoms: Herniated disc L1-2 flare up in June. Ear infection earlier this month

Healthcare visit (other): Phone call

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	Medical counselling	✓	·	✓
SD	Arthralgia	✓	✓	✓
SD	Bursitis	✓	✓	✓
SD	Condition aggravated	✓	·	✓
SD	Ear infection	✓	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Rotator cuff syndrome	✓	✓	✓
SD	Tendonitis	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Flushing	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	Nasopharyngitis	✓	✓	✓
SRO	No adverse event	○	○	○

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