3XV-40348-25853

3 vaccinations 11 coded responses 32 check-ins 11 free-text entries 0 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 801 / CO
Registered: 2021-04-05

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

2021-03-25
Dose 1 — Moderna
2021-04-05
Registered in v-safe
2021-04-05
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-08
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-22
Dose 2 — Moderna
2021-04-22
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Light headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Enlarged lymph node in neck on same side as injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Swollen lymph node in neck, same side as injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Swollen lymph node in neck , same side as injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Swollen lymph node still but is going down

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Swollen lymph node on the same side as injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — day 7, dose 2
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Swollen lymph node

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-20
Survey response — day 28, dose 2
MedDRA: Headache, Neuralgia, Pain — Feeling: Good

Free text: Short nerve pain on side of injection in temple/head.. it's not a full headache but will have a few short pulses of pain throughout the day for the last 5 days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-29
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-24
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-13
Dose 3 — Moderna
2021-12-14
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-15
Survey response — days 1–6 daily, dose 3
MedDRA: Arthralgia — Feeling: Good · Muscle or body aches

Free text: Soreness around shoulder of injection arm

MedDRA releases: 2024-11 · check-in free text available
2021-12-16
Survey response — days 1–6 daily, dose 3
MedDRA: Arthralgia, Neck pain — Feeling: Good · Muscle or body aches

Free text: Area between shoulder and neck sore on side of injection

MedDRA releases: 2024-11 · check-in free text available
2021-12-17
Survey response — days 1–6 daily, dose 3
MedDRA: Arthralgia, Neck pain — Feeling: Good · Site: Pain · Joint pains

Free text: Pain between shoulder and neck on injection site

MedDRA releases: 2024-11 · check-in free text available
2021-12-18
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-20
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-28
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-03
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-10
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-17
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-24
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-15
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-12-13
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-25	Moderna
2	2021-04-22	Moderna
3	2021-12-13	Moderna	No

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-23

Systemic reaction (other): Light headed

2021-04-24

Systemic reaction (other): Enlarged lymph node in neck on same side as injection site

2021-04-25

Systemic reaction (other): Swollen lymph node in neck, same side as injection

Release 8 — days 1–6 daily, dose 2

2021-04-26

Systemic reaction (other): Swollen lymph node in neck , same side as injection

2021-04-27

Systemic reaction (other): Swollen lymph node still but is going down

2021-04-28

Systemic reaction (other): Swollen lymph node on the same side as injection

Release 8 — day 7, dose 2

2021-04-29

Systemic reaction (other): Swollen lymph node

Release 8 — day 28, dose 2

2021-05-20

Symptoms: Short nerve pain on side of injection in temple/head.. it's not a full headache but will have a few short pulses of pain throughout the day for the last 5 days

Release 10 — days 1–6 daily, dose 3

2021-12-15

Systemic reaction (other): Soreness around shoulder of injection arm

2021-12-16

Systemic reaction (other): Area between shoulder and neck sore on side of injection

2021-12-17

Systemic reaction (other): Pain between shoulder and neck on injection site

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	Headache	✓	✓	✓
SD	Neuralgia	✓	✓	✓
SD	Pain	✓	✓	✓
SRO	Arthralgia	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Neck pain	·	·	✓

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