45L-24895-81301

3 vaccinations 10 coded responses 39 check-ins 10 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 917 / CA
Registered: 2021-02-18

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-02-18
Registered in v-safe
2021-02-19
Dose 1 — Moderna
2021-02-19
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache · Be unable to do your normal daily activities

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-26
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-05
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-12
Survey response — day 21, dose 1
MedDRA: Blood pressure diastolic increased, Blood pressure increased, Chest pain, Lymphadenopathy — Feeling: Good · Be unable to do your normal daily activities

Free text: My normally low blood pressure went so higher it was registering as error and I had some chest pain. That was yesterday and is better today. Also had swelling of a lymph node at back of head. Better now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Dose 2 — Moderna
2021-03-19
Health check-in — day 0, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-03-23
Survey response — days 1–6 daily, dose 2
MedDRA: Eye pain — Feeling: Good · Site: Pain

Free text: Eye pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-04-02
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-09
Survey response — day 21, dose 2
MedDRA: Lymphadenopathy — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Lymph node in left breast swollen. Same side as shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-16
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-23
Survey response — day 35, dose 2
MedDRA: Headache, Pain — Feeling: Fair

Free text: Not sure if related. But overall Ill feeling. Headache and aches in my shoulder and body.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Survey response — day 42, dose 2
MedDRA: Adverse reaction, Breast mass, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Abnormal ekg, lump in breast, enlarged uterus · Healthcare visit (other): Planned specialist visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-18
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-19
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 · Fever · Chills, Headache, 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
2021-12-08
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Swollen lymph nodes.

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Survey response — days 1–6 daily, dose 3
MedDRA: Lymph node pain — Feeling: Fair · Site: Pain · Fever · Headache

Free text: Pain on underarm lymph node

MedDRA releases: 2024-11 · check-in free text available
2021-12-10
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-12-12
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Nausea, Diarrhea, Abdominal pain

Adult check-in
2021-12-13
Survey response — day 7, dose 3
MedDRA: Lymph node pain — Feeling: Good

Free text: Still have pain in underarm lymph node

MedDRA releases: 2024-11 · check-in free text available
2021-12-20
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-27
Survey response — day 21, dose 3
MedDRA: Oropharyngeal pain — Feeling: Fair

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-01-03
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-10
Survey response — day 35, dose 3
MedDRA: Fatigue, Oropharyngeal pain — Feeling: Fair

Free text: Slight sore throat, fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-01-17
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-10
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-07
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-06
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-12-06
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-19	Moderna
2	2021-03-19	Moderna
3	2021-12-06	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 5 — day 21, dose 1

2021-03-12

Symptoms: My normally low blood pressure went so higher it was registering as error and I had some chest pain. That was yesterday and is better today. Also had swelling of a lymph node at back of head. Better now.

Release 6 — days 1–6 daily, dose 2

2021-03-23

Systemic reaction (other): Eye pain

Release 7 — day 21, dose 2

2021-04-09

Symptoms: Lymph node in left breast swollen. Same side as shot

Release 7 — day 35, dose 2

2021-04-23

Symptoms: Not sure if related. But overall Ill feeling. Headache and aches in my shoulder and body.

Release 8 — day 42, dose 2

2021-04-30

Symptoms: Abnormal ekg, lump in breast, enlarged uterus

Healthcare visit (other): Planned specialist visit

Release 10 — days 1–6 daily, dose 3

2021-12-08

Systemic reaction (other): Swollen lymph nodes.

2021-12-09

Systemic reaction (other): Pain on underarm lymph node

Release 10 — day 7, dose 3

2021-12-13

Systemic reaction (other): Still have pain in underarm lymph node

Release 10 — day 21, dose 3

2021-12-27

Symptoms: Sore throat

Release 10 — day 35, dose 3

2022-01-10

Symptoms: Slight sore throat, fatigue

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	Adverse reaction	✓	✓	✓
SD	Blood pressure diastolic increased	✓	✓	○
SD	Blood pressure increased	·	·	✓
SD	Breast mass	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	✓	✓	✓
SRO	Eye pain	✓	✓	✓
SRO	Lymph node pain	·	·	✓
SRO	Lymphadenopathy	·	·	✓

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