3XR-16702-90241

2 vaccinations 4 coded responses 25 check-ins 4 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 285 / NC
Registered: 2021-01-14

Relationship: Self
Race: Native Hawaiian or other Pacific Islander
Ethnicity: N/A

Timeline

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

2021-01-14
Registered in v-safe
2021-01-14
Dose 1 — Moderna
2021-01-14
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

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

Adult check-in
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: Ageusia — Feeling: Good · Site: Pain

Free text: Loss of taste.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-11
Dose 2 — Moderna
2021-02-11
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Epistaxis, Feeling abnormal — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Feel terrible, nosebleeds, shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-18
Health check-in — day 7, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-13
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Joint swelling, Peripheral swelling — Feeling: Fair · Be unable to do your normal daily activities

Free text: Joint pain and swelling in hands. Swelling and weeping in calves if both legs. Being treated at lymphademic clinic fir legs and by rheumatologist for swelling and pain in hands.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-12
Survey response — 6 months, dose 2
MedDRA: Dyspnoea, Fatigue, Office visit, Pneumonia, Psoriatic arthropathy, Pulmonary mass, Rheumatoid arthritis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Psoriatic rheumatoid arthritis, more shortness of breath, just got over pneumonia , extreme fatigue. Never had Psoriatic rheumatoid arthritis before now. Have nodules in lungs. · Healthcare visit (other): Visits with Pulmonary doctor and Rheumatologist.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-12
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)
2021-08-20
Call 1 — Left Voicemail
2022-02-11
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-14	Moderna
2	2021-02-11	Moderna

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-17

Systemic reaction (other): Loss of taste.

Release 4 — days 1–6 daily, dose 2

2021-02-13

Systemic reaction (other): Feel terrible, nosebleeds, shortness of breath

Release 8 — 3 months, dose 2

2021-05-13

Symptoms: Joint pain and swelling in hands. Swelling and weeping in calves if both legs. Being treated at lymphademic clinic fir legs and by rheumatologist for swelling and pain in hands.

Release 9 — 6 months, dose 2

2021-08-12

Symptoms: Psoriatic rheumatoid arthritis, more shortness of breath, just got over pneumonia , extreme fatigue. Never had Psoriatic rheumatoid arthritis before now. Have nodules in lungs.

Healthcare visit (other): Visits with Pulmonary doctor and Rheumatologist.

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	Office visit	✓	·	✓
SD	Arthralgia	✓	✓	✓
SD	Dyspnoea	✓	·	✓
SD	Fatigue	✓	·	✓
SD	Joint swelling	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pneumonia	✓	·	✓
SD	Psoriatic arthropathy	✓	·	✓
SD	Pulmonary mass	✓	·	✓
SD	Rheumatoid arthritis	✓	·	✓
SRO	Ageusia	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Epistaxis	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓

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