4D8-22310-34121

2 vaccinations 10 coded responses 19 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 535 / WI
Registered: 2021-04-17

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

2021-04-07
Dose 1 — Moderna
2021-04-17
Registered in v-safe
2021-04-17
Survey response — day 7, dose 1
MedDRA: Chest pain, Emergency care, Office visit, Pain, Pleurisy — Feeling: Fair · Be unable to work, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: On April 13 went to ER with severe shooting pain in the upper right side of my chest. Diagnosed with Pleurisy. Saw Dr. on 4/16 started Prednisone.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Report sent to call center — day 7, dose 1
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-21
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-28
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-05
Dose 2 — Moderna
2021-05-05
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-05-06
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy, Oropharyngeal pain — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Sore throat, gland swollen in throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy, Oropharyngeal pain — Feeling: Good · Site: Pain

Free text: Still a bit of swollen neck glands and sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Survey response — days 1–6 daily, dose 2
MedDRA: Oral pain, Oropharyngeal pain — Feeling: Good · Site: Pain

Free text: Still a weird sore throat and a soreness in my mouth

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Sore throat mild

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Good

Free text: I have been very itchy for past few days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus, Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: I have itching and rash like appearance for past few days; chest and both arms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-26
Health check-in — day 21, dose 2
Feeling: Good

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

Adult check-in
2021-06-09
Survey response — day 35, dose 2
MedDRA: Pain, Restlessness — Feeling: Fair

Free text: I have periodically experienced similar pain to when I went to the ER 6 days after my first shot. I also have been experiencing a restlessness with my nerves. If continues will visit doctor.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-06
Survey response — 3 months, dose 2
MedDRA: Gastric disorder — Feeling: Good

Free text: gastric issuesmaking appointment with doctor

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-03
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-12-21
Call 1 — Could Not Reach Participant
2021-12-29
Call 2 — Could Not Reach Participant
2022-05-05
Survey response — 12 months, dose 2
MedDRA: Cough, Fatigue — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Had a heavy cough and fatigue for nearly the whole month of April. Finally getting back to normal.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-07	Moderna
2	2021-05-05	Moderna

Call center

1 call center case

1 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 7 — day 7, dose 1

2021-04-17

Systemic reaction (other): On April 13 went to ER with severe shooting pain in the upper right side of my chest. Diagnosed with Pleurisy. Saw Dr. on 4/16 started Prednisone.

Release 8 — days 1–6 daily, dose 2

2021-05-06

Systemic reaction (other): Sore throat, gland swollen in throat

2021-05-07

Systemic reaction (other): Still a bit of swollen neck glands and sore throat

2021-05-08

Systemic reaction (other): Still a weird sore throat and a soreness in my mouth

2021-05-09

Systemic reaction (other): Sore throat mild

2021-05-10

Systemic reaction (other): I have been very itchy for past few days.

2021-05-11

Systemic reaction (other): I have itching and rash like appearance for past few days; chest and both arms

Release 9 — day 35, dose 2

2021-06-09

Symptoms: I have periodically experienced similar pain to when I went to the ER 6 days after my first shot. I also have been experiencing a restlessness with my nerves. If continues will visit doctor.

Release 9 — 3 months, dose 2

2021-08-06

Symptoms: gastric issuesmaking appointment with doctor

Release 11 — 12 months, dose 2

2022-05-05

Symptoms: Had a heavy cough and fatigue for nearly the whole month of April. Finally getting back to normal.

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	Cough	·	·	✓
SD	Fatigue	·	·	✓
SD	Gastric disorder	✓	·	✓
SD	Pain	✓	✓	✓
SD	Restlessness	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Office visit	✓	✓	✓
SRO	Oral pain	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pleurisy	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Rash	✓	✓	✓

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