4BC-33896-38657

3 vaccinations 9 coded responses 35 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 958 / CA
Registered: 2021-02-04

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

2021-02-04
Registered in v-safe
2021-02-04
Dose 1 — Moderna
2021-02-04
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Joint pains, Fatigue or tiredness, Diarrhea · Be unable to work

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-09
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary pain — Feeling: Good · Site: Pain

Free text: Pain/soreness in armpit for the past several days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary pain — Feeling: Good · Site: Pain · Joint pains

Free text: Soreness in my armpit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-05
Dose 2 — Moderna
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache · Be unable to work

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-12
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-19
Survey response — day 14, dose 2
MedDRA: Rash — Feeling: Good

Free text: Rash

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-04
Survey response — 3 months, dose 2
MedDRA: Rash — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Rash on chest and neck for a couple of months. I have seen a doctor for this and he is unsure of what it is.

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

1 call case(s)
2021-09-05
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-23
Dose 3 — Moderna
2021-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-26
Survey response — days 1–6 daily, dose 3
MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Weird rash on my earlobe on the same sight as injection.

MedDRA releases: 2024-11 · check-in free text available
2021-10-27
Survey response — days 1–6 daily, dose 3
MedDRA: Unevaluable event — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: On earlobe - same side as injection

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Survey response — days 1–6 daily, dose 3
MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Rash on ear of same side of body I got the injection.

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-06
Survey response — day 14, dose 3
MedDRA: Rash macular, Tongue eruption — Feeling: Good

Free text: Red blotchy spots on tongue

MedDRA releases: 2024-11 · check-in free text available
2021-11-13
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-20
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-27
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-05
Health check-in — day 42, dose 3
Feeling: Good

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

Adult check-in
2022-01-31
Call 1 — Left Voicemail
2022-04-25
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-25
Survey response — 12 months, dose 3
MedDRA: Office visit, Tongue discomfort, Tongue erythema, Tongue geographic — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Persistent red spot on my tongue accompanied by burning sensation. Geographic tongue. · Healthcare visit (other): In person visit with a head and neck specialist and my primary care physician as well.

MedDRA releases: 2024-11 · check-in free text available
2022-10-25
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-26
Call successful
Not applicable - Accidental Reporting
2022-10-26
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-04	Moderna
2	2021-03-05	Moderna
3	2021-10-23	Moderna	No

Call center

2 call center cases

2 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-09

Systemic reaction (other): Pain/soreness in armpit for the past several days

Release 4 — days 1–6 daily, dose 1

2021-02-10

Systemic reaction (other): Soreness in my armpit

Release 5 — day 14, dose 2

2021-03-19

Symptoms: Rash

Release 8 — 3 months, dose 2

2021-06-04

Symptoms: Rash on chest and neck for a couple of months. I have seen a doctor for this and he is unsure of what it is.

Release 10 — days 1–6 daily, dose 3

2021-10-26

Systemic reaction (other): Weird rash on my earlobe on the same sight as injection.

2021-10-27

Systemic reaction (other): On earlobe - same side as injection

2021-10-29

Systemic reaction (other): Rash on ear of same side of body I got the injection.

Release 10 — day 14, dose 3

2021-11-06

Symptoms: Red blotchy spots on tongue

Release 12 — 12 months, dose 3

2022-10-25

Symptoms: Persistent red spot on my tongue accompanied by burning sensation. Geographic tongue.

Healthcare visit (other): In person visit with a head and neck specialist and my primary care physician as well.

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	Rash	✓	✓	✓
SD	Rash macular	·	·	✓
SD	Tongue discomfort	·	·	✓
SD	Tongue eruption	·	·	✓
SD	Tongue erythema	·	·	✓
SD	Tongue geographic	·	·	✓
SRO	Axillary pain	✓	✓	✓
SRO	Rash	·	·	✓
SRO	Unevaluable event	·	·	✓

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