4DX-71204-99358

4 vaccinations 3 coded responses 41 check-ins 3 free-text entries 0 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 208 / MD
Registered: 2021-01-12

Relationship: Self
Race: N/A
Ethnicity: Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-01-12
Registered in v-safe
2021-01-12
Dose 1 — Moderna
2021-01-12
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-01-13
Survey response — days 1–6 daily, dose 1
MedDRA: Impaired work ability, Loss of personal independence in daily activities, Pain, Self-medication — Feeling: Good · Site: Pain

Free text: I did take 2 Advils last night and this morning as the pain was interfiring with my daily work

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-26
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site swelling, Injection site warmth — Feeling: Fair

Free text: Swelling , increased warmth and redness in my arm. Area 7 by 3 inches This is around the injection site

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

Adult check-in
2021-02-09
Dose 2 — Moderna
2021-02-09
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · None

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · None

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-16
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-18
Survey response — day 35, dose 2
MedDRA: Arthralgia, Injection site erythema, Injection site pain, Injection site swelling — Feeling: Fair · Be unable to do your normal daily activities

Free text: Bilateral shoulder pain. This is new. I wonder if it is related to the Moderna. I do have a considerable local reaction with redness, swelling and pain at the injection site. Perhaps my shoulder pains are autoimmune?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-10
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-26
Dose 3 — Moderna
2021-10-26
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Joint pains · Be unable to do your normal daily activities

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · Joint pains

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · Rash, not including the immediate area around the injection site

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-02
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-09
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-16
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-23
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-01
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-27
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-27
Dose 4 — Moderna
2022-04-19
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-04-24
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-01
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-09
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-06-27
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-27
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-12	Moderna
2	2021-02-09	Moderna
3	2021-10-26	Moderna	No
4	2022-03-27	Moderna	No

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-13

Systemic reaction (other): I did take 2 Advils last night and this morning as the pain was interfiring with my daily work

Release 2 — day 14, dose 1

2021-01-26

Symptoms: Swelling , increased warmth and redness in my arm. Area 7 by 3 inches This is around the injection site

Release 5 — day 35, dose 2

2021-03-18

Symptoms: Bilateral shoulder pain. This is new. I wonder if it is related to the Moderna. I do have a considerable local reaction with redness, swelling and pain at the injection site. Perhaps my shoulder pains are autoimmune?

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	Arthralgia	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SRO	Impaired work ability	✓	✓	✓
SRO	Loss of personal independence in daily activities	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Self-medication	✓	✓	✓

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