3WK-29731-06553

3 vaccinations 11 coded responses 34 check-ins 11 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 144 / NY
Registered: 2021-01-15

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

2021-01-13
Dose 1 — Moderna
2021-01-15
Registered in v-safe
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal pain — Feeling: Fair · Chills, Abdominal pain · Be unable to do your normal daily activities

Free text: 5 hours mild/moderate abdominal cramps

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-17
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-20
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-03
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-10
Dose 2 — Moderna
2021-02-10
Health check-in — day 0, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Herpes zoster — Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Start of shingle on back in recurrent spot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Herpes zoster — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Still have Shingle, but staying 1 diameter, pink

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Blister, Erythema, Herpes zoster, Pain, Pruritus — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Shingle 1 diameter, on back, itching, pain, blisters, less red

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Dry skin, Herpes zoster — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Shingle 1 diameter, less itch, drying up, pink. Dizziness today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Survey response — days 1–6 daily, dose 2
MedDRA: Herpes zoster — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Shingle is drying up no more tingle or itch

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — day 7, dose 2
MedDRA: Herpes zoster — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Shingle is drying and no longer itches or tingles

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-12
Survey response — 6 months, dose 2
MedDRA: Blood pressure increased — Feeling: Good

Free text: Elevated blood pressure

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-20
Dose 3 — Moderna
2021-11-23
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy, Oedema peripheral — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Fatigue or tiredness · Be unable to work or attend school

Free text: Swollen lymph with edema same armpit as shot

MedDRA releases: 2024-11 · check-in free text available
2021-11-24
Survey response — days 1–6 daily, dose 3
MedDRA: Oedema peripheral — Feeling: Good

Free text: I still have some edema under my right injection arm, armpit the size of lemon but seems to be slowly absorbing

MedDRA releases: 2024-11 · check-in free text available
2021-11-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-28
Survey response — day 7, dose 3
MedDRA: Rash, Scab — Feeling: Good

Free text: Had belly button rash which only noticed today as scabbed

MedDRA releases: 2024-11 · check-in free text available
2021-12-04
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-11
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-18
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-25
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-01
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-19
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-21
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-20
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Moderna
2	2021-02-10	Moderna
3	2021-11-20	Moderna	No

Call center

1 call center case

1 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-17

Systemic reaction (other): 5 hours mild/moderate abdominal cramps

Release 4 — days 1–6 daily, dose 2

2021-02-12

Systemic reaction (other): Start of shingle on back in recurrent spot

2021-02-13

Systemic reaction (other): Still have Shingle, but staying 1 diameter, pink

2021-02-14

Systemic reaction (other): Shingle 1 diameter, on back, itching, pain, blisters, less red

2021-02-15

Systemic reaction (other): Shingle 1 diameter, less itch, drying up, pink. Dizziness today.

2021-02-16

Systemic reaction (other): Shingle is drying up no more tingle or itch

Release 4 — day 7, dose 2

2021-02-17

Systemic reaction (other): Shingle is drying and no longer itches or tingles

Release 9 — 6 months, dose 2

2021-08-12

Symptoms: Elevated blood pressure

Release 10 — days 1–6 daily, dose 3

2021-11-23

Systemic reaction (other): Swollen lymph with edema same armpit as shot

2021-11-24

Systemic reaction (other): I still have some edema under my right injection arm, armpit the size of lemon but seems to be slowly absorbing

Release 10 — day 7, dose 3

2021-11-28

Systemic reaction (other): Had belly button rash which only noticed today as scabbed

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	Blood pressure increased	✓	·	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Blister	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dry skin	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Herpes zoster	✓	✓	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Oedema peripheral	·	·	✓
SRO	Pain	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Rash	·	·	✓
SRO	Scab	·	·	✓

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