4DB-14453-34131

3 vaccinations 7 coded responses 24 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 900 / CA
Registered: 2021-02-11

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-02-10
Dose 1 — Moderna
2021-02-11
Registered in v-safe
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Chills, Headache, Joint pains, Abdominal pain

Adult check-in
2021-02-13
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Headache

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Abdominal pain

Adult check-in
2021-02-16
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea — Feeling: Fair · Headache

Free text: Shortness of Breathe

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-10
Dose 2 — Moderna
2021-03-10
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-11
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Good · Be unable to do your normal daily activities

Free text: Back ache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Good

Free text: Back ache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-15
Survey response — days 1–6 daily, dose 2
MedDRA: Emergency care, Pruritus, Urticaria — Feeling: Good · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Systemic reaction (other): Went to ER today for hives and itching ,got Benadryl shot and 60 mg of prednisone · Healthcare visit (other): I had hives and itching all over my body today. Got Benadryl shot and 60mg of Prednisone

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-16
Survey response — days 1–6 daily, dose 2
MedDRA: Office visit, Rash — Feeling: Good · None · Get care from a doctor or other healthcare professional

Free text: Went to Dermatologist today for skin rash break out.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-17
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-14
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-21
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-09
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-09
Survey response — 6 months, dose 2
MedDRA: Cholelithiasis, Discomfort, Headache — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Left rib cage discomfort like when I had pneumonia of the left lung and coughing and mucus,I have gallstones gallbladder needs to be removed,headaches,like when I had Covid.

MedDRA releases: 2024-11 · check-in free text available
2021-09-09
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-10
Call 1 — Could Not Reach Participant
2021-09-14
Call 2 — Could Not Reach Participant
2021-12-23
Dose 3 — Moderna
2022-03-14
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-12-24
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-10	Moderna
2	2021-03-10	Moderna
3	2021-12-23	Moderna	No

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-13

Systemic reaction (other): No

2021-02-16

Systemic reaction (other): Shortness of Breathe

Release 5 — days 1–6 daily, dose 2

2021-03-11

Systemic reaction (other): Back ache

2021-03-12

Systemic reaction (other): Back ache

2021-03-15

Systemic reaction (other): Went to ER today for hives and itching ,got Benadryl shot and 60 mg of prednisone

Healthcare visit (other): I had hives and itching all over my body today. Got Benadryl shot and 60mg of Prednisone

2021-03-16

Healthcare visit (other): Went to Dermatologist today for skin rash break out.

Release 9 — 6 months, dose 2

2021-09-09

Symptoms: Left rib cage discomfort like when I had pneumonia of the left lung and coughing and mucus,I have gallstones gallbladder needs to be removed,headaches,like when I had Covid.

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	✓	✓	✓
HCVO	Pruritus	✓	✓	✓
HCVO	Rash	✓	✓	✓
HCVO	Urticaria	✓	✓	✓
SD	Cholelithiasis	·	·	✓
SD	Discomfort	·	·	✓
SD	Headache	·	·	✓
SRO	Back pain	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Urticaria	✓	✓	✓

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