3WZ-14791-55998

3 vaccinations 5 coded responses 36 check-ins 5 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 321 / FL
Registered: 2021-03-03

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-03-03
Registered in v-safe
2021-03-03
Dose 1 — Moderna
2021-03-03
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Musculoskeletal discomfort, Musculoskeletal pain — Feeling: Good · Muscle or body aches

Free text: Ache and discomfort at left shoulder blade and left part of lower neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain, Limb discomfort, Musculoskeletal pain, Pain in extremity — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Very mild discomfort and ache in left arm injection site and shoulder blade

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-05
Dose 2 — Moderna
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Headache, Pain — Feeling: Good · Site: Pain · Be unable to do your normal daily activities

Free text: On APRIL 6 ( day after second vaccine) I had chills, body aches and headache across my eyes and temples. Today none

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site discomfort — Feeling: Good · Site: Pain

Free text: Minor discomfort at injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-06
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-06
Dose 3 — Moderna
2021-12-07
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-12-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-12-10
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-12-12
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-12-14
Health check-in — day 7, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-12-20
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-30
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-03
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-17
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-09
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-06
Survey response — 6 months, dose 3
MedDRA: Abdominal pain lower, Cough, Fatigue, Rhinorrhoea, SARS-CoV-2 test — Feeling: Fair · Be unable to do your normal daily activities

Free text: Cough, tire easily, occasional sharp pain in lower left abdomen, runny nose constantly , took at home Covid test

MedDRA releases: 2024-11 · check-in free text available
2022-12-06
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Moderna
2	2021-04-05	Moderna
3	2021-12-06	Moderna	No

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-04

Systemic reaction (other): Ache and discomfort at left shoulder blade and left part of lower neck

2021-03-05

Systemic reaction (other): Very mild discomfort and ache in left arm injection site and shoulder blade

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): On APRIL 6 ( day after second vaccine) I had chills, body aches and headache across my eyes and temples. Today none

2021-04-08

Systemic reaction (other): Minor discomfort at injection

Release 11 — 6 months, dose 3

2022-06-06

Symptoms: Cough, tire easily, occasional sharp pain in lower left abdomen, runny nose constantly , took at home Covid test

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	Abdominal pain lower	·	·	✓
SD	Cough	·	·	✓
SD	Fatigue	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test	·	·	✓
SRO	Chills	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site discomfort	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Limb discomfort	✓	✓	✓
SRO	Musculoskeletal discomfort	✓	✓	✓
SRO	Musculoskeletal pain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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