3U9-13395-86791

4 vaccinations 8 coded responses 53 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 242 / VA
Registered: 2021-03-21

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

2021-03-19
Dose 1 — Moderna
2021-03-21
Registered in v-safe
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-02
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-17
Dose 2 — Moderna
2021-04-17
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Itching · Chills, Muscle or body aches

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Nausea

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Fever · None

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-24
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-01
Survey response — day 14, dose 2
MedDRA: Antiphospholipid antibodies, Fatigue, Muscular weakness, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: I have lupus and possible dermatomyositis. Im experiencing weak muscles and fatigued so Im not sure if Im having a flare up or maybe just lingering symptoms from the vaccine. I have a rheumatologist appt May 4...

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-29
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-17
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-08-17
Dose 3 — Moderna
2021-08-17
Health check-in — day 0, dose 3
Feeling: Fair · Headache, Nausea

Adult check-in
2021-08-18
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Fever · Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-08-19
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Muscle or body aches, Nausea

Adult check-in
2021-08-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling, Itching · Fever · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-08-21
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Headache, Nausea

Adult check-in
2021-08-22
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-08-23
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-08-24
Health check-in — day 7, dose 3
Feeling: Fair · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-08-31
Survey response — day 14, dose 3
MedDRA: Condition aggravated, Pre-existing disease, Systemic lupus erythematosus — Feeling: Fair

Free text: I have lupus/dermatomyositis. Ive experienced a small flare up of symptoms which I have done after each shot. It usually subsided after couple of weeks.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-07
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-09-14
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-09-21
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-09-28
Survey response — day 42, dose 3
MedDRA: Pre-existing disease, Rash — Feeling: Fair

Free text: I have lupus/dermatomyositis and have had an increase in rashes but I could just be having a flare up.

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Survey response — 3 months, dose 3
MedDRA: Condition aggravated, Fatigue, Muscular weakness, Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I'm currently having a flare up with my dermatomyositis. Extreme fatigue, muscle weakness.

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Report sent to call center — 3 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-17
Call 3 — Left Voicemail
2022-02-15
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-08-17
Health check-in — 12 months, dose 3
Feeling: Poor

Adult check-in
2022-09-27
Dose 4 — Moderna
Co-administered: Flu
2022-09-27
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-09-28
Survey response — days 1–6 daily, dose 4
MedDRA: Condition aggravated, Pre-existing disease, Systemic lupus erythematosus — Feeling: Fair · Site: Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: I have lupus/dermatomyositis. In my experience each time they get COVID vax my normal symptoms increase for 24 to 48 hours.

MedDRA releases: 2024-11 · check-in free text available
2022-09-29
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Swelling, Itching · Fever · Chills, Joint pains, Fatigue or tiredness, Nausea

Adult check-in
2022-09-30
Survey response — days 1–6 daily, dose 4
MedDRA: Dizziness — Feeling: Fair · Site: Redness, Itching · Fever · Nausea

Free text: Dizzy

MedDRA releases: 2024-11 · check-in free text available
2022-10-01
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Swelling · Fatigue or tiredness, Nausea

Adult check-in
2022-10-03
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-10-04
Health check-in — day 7, dose 4
Feeling: Fair · Fever · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-10-11
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-18
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-10-25
Survey response — day 28, dose 4
MedDRA: Breast mass, Chest pain, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I'm having some pain left side chest but have since found a lump or something at bottom left breast. I have made an appt to get it checked but don't think the vaccine is the cause. · Healthcare visit (other): I have an appt with Ob/gyn doctor.

MedDRA releases: 2024-11 · check-in free text available
2022-10-25
Report sent to call center — day 28, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-26
Call 2 — Left Voicemail
2022-10-26
Call 2 — Left Voicemail
2022-11-01
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-08
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-27
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2023-03-28
Survey response — 6 months, dose 4
MedDRA: Pre-existing disease, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-03-28
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2023-03-29
Call 1 — Left Voicemail
2023-03-29
Call 1 — Left Voicemail
2023-03-29
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-19	Moderna
2	2021-04-17	Moderna
3	2021-08-17	Moderna	No
4	2022-09-27	Moderna	Flu

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 8 — day 14, dose 2

2021-05-01

Symptoms: I have lupus and possible dermatomyositis. Im experiencing weak muscles and fatigued so Im not sure if Im having a flare up or maybe just lingering symptoms from the vaccine. I have a rheumatologist appt May 4...

Release 9 — day 14, dose 3

2021-08-31

Symptoms: I have lupus/dermatomyositis. Ive experienced a small flare up of symptoms which I have done after each shot. It usually subsided after couple of weeks.

Release 9 — day 42, dose 3

2021-09-28

Symptoms: I have lupus/dermatomyositis and have had an increase in rashes but I could just be having a flare up.

Release 10 — 3 months, dose 3

2021-11-16

Symptoms: I'm currently having a flare up with my dermatomyositis. Extreme fatigue, muscle weakness.

Release 12 — days 1–6 daily, dose 4

2022-09-28

Systemic reaction (other): I have lupus/dermatomyositis. In my experience each time they get COVID vax my normal symptoms increase for 24 to 48 hours.

2022-09-30

Systemic reaction (other): Dizzy

Release 12 — day 28, dose 4

2022-10-25

Symptoms: I'm having some pain left side chest but have since found a lump or something at bottom left breast. I have made an appt to get it checked but don't think the vaccine is the cause.

Healthcare visit (other): I have an appt with Ob/gyn doctor.

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	Unevaluable event	·	·	✓
SD	Antiphospholipid antibodies	✓	✓	✓
SD	Breast mass	·	·	✓
SD	Chest pain	·	·	✓
SD	Condition aggravated	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Muscular weakness	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rash	·	·	✓
SD	Systemic lupus erythematosus	✓	·	✓
SRO	Condition aggravated	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Systemic lupus erythematosus	·	·	✓

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