48J-29040-56510

2 vaccinations 6 coded responses 26 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 546 / WI
Registered: 2021-02-03

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

Timeline

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

2021-02-03
Registered in v-safe
2021-02-04
Dose 1 — Moderna
2021-02-04
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-02-05
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Neck pain — Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Neck and shoulder pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-18
Survey response — day 14, dose 1
MedDRA: Headache, Injection site pain, Injection site pruritus — Feeling: Fair

Free text: Day 8 I experienced pain at the injection site and extreme itch, just lasted the day. Headache on and off again

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-04
Dose 2 — Moderna
2021-03-04
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills

Adult check-in
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Neck mass, Swelling — Feeling: Fair · Fatigue or tiredness, Diarrhea · Be unable to work

Free text: Swollen lump on neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Still have the swollen lump or node on my neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-10
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Office visit — Feeling: Fair · Headache · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Went to urgent care and reviewed a shot of imitrex for headache.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-11
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-03
Survey response — 3 months, dose 2
MedDRA: Headache, Office visit — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Headache frequency has increased. Have since started taking a daily headache prevention medication as well has being prescribed a medication to take on the onset or first symptom of a migraine. · Healthcare visit (other): Twice to urgent care, once to clinic

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Report sent to call center — 3 months, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-18
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-06-18
Call successful
Does not wish to fill out VAERS report
2021-09-04
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-03-06
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-04	Moderna
2	2021-03-04	Moderna

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-05

Systemic reaction (other): Neck and shoulder pain

Release 4 — day 14, dose 1

2021-02-18

Symptoms: Day 8 I experienced pain at the injection site and extreme itch, just lasted the day. Headache on and off again

Release 5 — days 1–6 daily, dose 2

2021-03-07

Systemic reaction (other): Swollen lump on neck

2021-03-08

Systemic reaction (other): Still have the swollen lump or node on my neck

2021-03-10

Systemic reaction (other): Went to urgent care and reviewed a shot of imitrex for headache.

Release 8 — 3 months, dose 2

2021-06-03

Symptoms: Headache frequency has increased. Have since started taking a daily headache prevention medication as well has being prescribed a medication to take on the onset or first symptom of a migraine.

Healthcare visit (other): Twice to urgent care, once to clinic

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	Headache	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Neck mass	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Office visit	✓	✓	✓
SRO	Swelling	✓	✓	✓

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