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4AV-10539-99254

2 vaccinations 6 coded responses 23 check-ins 6 free-text entries 2 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
597 / MT
Registered
2021-01-31
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-29
    Dose 1 — Moderna
  2. 2021-01-31
    Registered in v-safe
  3. 2021-02-01
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Headache
    Adult check-in
  4. 2021-02-02
    Survey response — days 1–6 daily, dose 1
    MedDRA: Chills, Diarrhoea, Headache, Injection site erythema, Injection site reaction, Injection site swelling, Injection site warmth, Limb discomfort, Pain, Pain in extremity, Pyrexia — Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness
    Free text: I incorrectly reported on yesterdays form. I got vaccine 1/29/21 & had painful reaction on 1/30/ 21 through early AM on 2/1/21. Symptoms included swelling at site , redness , hot to the touch , very painful to move my arm, headache, diarrhea , fever, chills, & body aches . Symptoms present from mid- morning 1/30 until about 1-2 am on 2/1/21. No symptoms or paiin since then, other than slightly sore upper arm on 2/1/21. No symptoms on 2/2/21.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-02-03
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Redness, Swelling · None
    Adult check-in
  6. 2021-02-04
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Redness, Swelling · None
    Adult check-in
  7. 2021-02-06
    Survey response — day 7, dose 1
    MedDRA: Injection site induration, Injection site scab — Feeling: Good · Site: Pain, Redness, Swelling · Headache
    Free text: Hard bump & scab at injection site on L arm
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-02-12
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  9. 2021-02-19
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-02-26
    Dose 2 — Moderna
  11. 2021-02-26
    Health check-in — day 0, dose 2
    Feeling: Good · None
    Adult check-in
  12. 2021-02-27
    Survey response — days 1–6 daily, dose 2
    MedDRA: Dyspnoea — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to work, Be unable to do your normal daily activities
    Free text: Short of breath
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-02-28
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  14. 2021-03-01
    Survey response — days 1–6 daily, dose 2
    MedDRA: Asthma, Pre-existing disease — Feeling: Fair · Site: Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: Increased asthma response
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-03-02
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  16. 2021-03-03
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  17. 2021-03-04
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  18. 2021-03-05
    Health check-in — day 7, dose 2
    Feeling: Good · Headache, Fatigue or tiredness
    Adult check-in
  19. 2021-03-12
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-03-19
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-03-26
    Survey response — day 28, dose 2
    MedDRA: Cough, Dyspnoea, Headache, Oropharyngeal pain, Pyrexia, Respiratory tract congestion — Feeling: Poor · 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: Intermittent fever, headache, short of breath, congested, coughing, sore throat
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-03-26
    Report sent to call center — day 28, 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)
  23. 2021-04-03
    Survey response — day 35, dose 2
    MedDRA: Headache, Influenza like illness, Oropharyngeal pain, Pain — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Flu like symptoms: headache, sore throat, body aches,
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  24. 2021-04-03
    Report sent to call center — day 35, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  25. 2021-04-10
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-05-28
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-06-14
  28. 2021-08-27
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  29. 2022-02-26
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-29Moderna
22021-02-26Moderna

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-02

Systemic reaction (other): I incorrectly reported on yesterdays form. I got vaccine 1/29/21 & had painful reaction on 1/30/ 21 through early AM on 2/1/21. Symptoms included swelling at site , redness , hot to the touch , very painful to move my arm, headache, diarrhea , fever, chills, & body aches . Symptoms present from mid- morning 1/30 until about 1-2 am on 2/1/21. No symptoms or paiin since then, other than slightly sore upper arm on 2/1/21. No symptoms on 2/2/21.

Release 3 — day 7, dose 1

2021-02-06

Systemic reaction (other): Hard bump & scab at injection site on L arm

Release 4 — days 1–6 daily, dose 2

2021-02-27

Systemic reaction (other): Short of breath

2021-03-01

Systemic reaction (other): Increased asthma response

Release 6 — day 28, dose 2

2021-03-26

Symptoms: Intermittent fever, headache, short of breath, congested, coughing, sore throat

Release 6 — day 35, dose 2

2021-04-03

Symptoms: Flu like symptoms: headache, sore throat, body aches,

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

FieldPreferred term2021-092023-042024-11
SDCough ✓ ✓ ✓
SDDyspnoea ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDInfluenza like illness ✓ ✓ ✓
SDOropharyngeal pain ✓ ✓ ✓
SDPain ✓ ✓ ✓
SDPyrexia ✓ ✓ ✓
SDRespiratory tract congestion ✓ ✓ ✓
SROAsthma ✓ ✓ ✓
SROChills ✓ ✓ ✓
SRODiarrhoea ✓ ✓ ✓
SRODyspnoea ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SROInjection site erythema ✓ ✓ ✓
SROInjection site induration ✓ ✓ ✓
SROInjection site reaction ✓ ✓ ✓
SROInjection site scab ✓ ✓ ✓
SROInjection site swelling ✓ ✓ ✓
SROInjection site warmth ✓ ✓ ✓
SROLimb discomfort ✓ ✓ ✓
SROPain ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROPre-existing disease ✓ · ✓
SROPyrexia ✓ ✓ ✓

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

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