3YN-12374-12709

2 vaccinations 16 coded responses 24 check-ins 16 free-text entries 0 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 336 / FL
Registered: 2021-09-02

Relationship: Self
Race: Asian
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

2021-09-02
Registered in v-safe
2021-09-02
Dose 1 — Moderna
2021-09-02
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-09-03
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Neck pain, Pain — Feeling: Poor · Site: Pain, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Radiating Neck and shoulder pain

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-04
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Itching all over torso

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-05
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-07
Survey response — days 1–6 daily, dose 1
MedDRA: Brain fog, Memory impairment — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Mind fog, forgetfulness

MedDRA releases: 2024-11 · check-in free text available
2021-09-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-09-09
Survey response — day 7, dose 1
MedDRA: Hyperhidrosis — Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Sweating

MedDRA releases: 2024-11 · check-in free text available
2021-09-16
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-09-25
Survey response — day 21, dose 1
MedDRA: Muscle tightness, Pruritus, Tenderness — Feeling: Good

Free text: Itchy torso no rash, tight muscles and tenderness on arm that was injected with vaccine

MedDRA releases: 2024-11 · check-in free text available
2021-10-02
Survey response — day 28, dose 1
MedDRA: Alopecia, Dizziness, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Hair loss, dizzy ,headaches

MedDRA releases: 2024-11 · check-in free text available
2021-10-09
Dose 2 — Moderna
2021-10-09
Health check-in — day 0, dose 2
Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-10-10
Survey response — days 1–6 daily, dose 2
MedDRA: Pain in extremity — Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Leg pain

MedDRA releases: 2024-11 · check-in free text available
2021-10-11
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Back pain

MedDRA releases: 2024-11 · check-in free text available
2021-10-12
Survey response — days 1–6 daily, dose 2
MedDRA: Rash — Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Rash on face

MedDRA releases: 2024-11 · check-in free text available
2021-10-14
Survey response — days 1–6 daily, dose 2
MedDRA: Anxiety — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Anxiety

MedDRA releases: 2024-11 · check-in free text available
2021-10-15
Survey response — days 1–6 daily, dose 2
MedDRA: Abnormal dreams — Feeling: Fair · Fever · Headache, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Vivid dreams every day

MedDRA releases: 2024-11 · check-in free text available
2021-10-18
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-10-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-10-30
Survey response — day 21, dose 2
MedDRA: Cough, Oropharyngeal pain — Feeling: Good

Free text: Sore throat cough

MedDRA releases: 2024-11 · check-in free text available
2021-11-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-11-13
Survey response — day 35, dose 2
MedDRA: Headache, Nasopharyngitis, Oropharyngeal pain, Rhinorrhoea, Vertigo — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Cold symptoms , vertigo, headaches, runny nose, sore throat

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Survey response — day 42, dose 2
MedDRA: Fatigue, Muscle tightness, Vertigo — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Jaw tightness, vertigo, fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-01-08
Survey response — 3 months, dose 2
MedDRA: Chills, Cough, Pain, Pyrexia, Respiratory disorder — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Fever cough body ache chills respiratory difficulties

MedDRA releases: 2024-11 · check-in free text available
2022-04-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-09-02	Moderna	No
2	2021-10-09	Moderna	No

Free text

Release 9 — days 1–6 daily, dose 1

2021-09-03

Systemic reaction (other): Radiating Neck and shoulder pain

2021-09-04

Systemic reaction (other): Itching all over torso

2021-09-05

Systemic reaction (other): Dizziness

2021-09-07

Systemic reaction (other): Mind fog, forgetfulness

Release 9 — day 7, dose 1

2021-09-09

Systemic reaction (other): Sweating

Release 9 — day 21, dose 1

2021-09-25

Symptoms: Itchy torso no rash, tight muscles and tenderness on arm that was injected with vaccine

Release 9 — day 28, dose 1

2021-10-02

Symptoms: Hair loss, dizzy ,headaches

Release 10 — days 1–6 daily, dose 2

2021-10-10

Systemic reaction (other): Leg pain

2021-10-11

Systemic reaction (other): Back pain

2021-10-12

Systemic reaction (other): Rash on face

2021-10-14

Systemic reaction (other): Anxiety

2021-10-15

Systemic reaction (other): Vivid dreams every day

Release 10 — day 21, dose 2

2021-10-30

Symptoms: Sore throat cough

Release 10 — day 35, dose 2

2021-11-13

Symptoms: Cold symptoms , vertigo, headaches, runny nose, sore throat

Release 10 — day 42, dose 2

2021-11-20

Symptoms: Jaw tightness, vertigo, fatigue

Release 10 — 3 months, dose 2

2022-01-08

Symptoms: Fever cough body ache chills respiratory difficulties

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	Alopecia	·	·	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	Dizziness	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Muscle tightness	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pruritus	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory disorder	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Tenderness	·	·	✓
SD	Vertigo	·	·	✓
SRO	Abnormal dreams	·	·	✓
SRO	Anxiety	·	·	✓
SRO	Arthralgia	✓	·	✓
SRO	Back pain	·	·	✓
SRO	Brain fog	·	·	✓
SRO	Dizziness	✓	·	✓
SRO	Hyperhidrosis	·	·	✓
SRO	Memory impairment	·	·	✓
SRO	Neck pain	✓	·	✓
SRO	Pain	✓	·	✓
SRO	Pain in extremity	·	·	✓
SRO	Pruritus	✓	·	✓
SRO	Rash	·	·	✓

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