4E6-62375-42039

Timeline

1. 2021-04-30
   Dose 1 — Moderna
2. 2021-05-02
   Registered in v-safe
3. 2021-05-02
   Survey response — days 1–6 daily, dose 1

   MedDRA: Taste disorder — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

   Free text: foul taste in mouth

   MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
4. 2021-05-03
   Survey response — days 1–6 daily, dose 1

   MedDRA: Headache, Pre-existing disease — Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness

   Free text: Don't usually have headaches. I have lupus & fibro & getting over a fungus infection & lupus flare up. And I'm a Covid long hauler since Oct

   MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
5. 2021-05-04
   Survey response — days 1–6 daily, dose 1

   MedDRA: Pain in extremity, Rash, Tenderness — Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

   Free text: Arm is still sore but getting better. Have had rash since covid but today seems rashed area has increased and more tender to touch.

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

   MedDRA: Condition aggravated, Headache, Injection site pain, Pre-existing disease, Rash — Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

   Free text: Still pain in left arm where vaccination injection is. Never had headaches til vaccination. Rash varies Covid? Fungus? Lupus?muscle body aches fibro? Lupus? Herniated disks (3)? Back pain. Covid made it worse. Fatique tiredness no strength since covid 10/16/2020

   MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
7. 2021-05-06
   Survey response — days 1–6 daily, dose 1

   MedDRA: Injection site bruising, Pain in extremity — Feeling: Fair · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

   Free text: Sharp pain upper left thigh when standing. Still pain in left arm and still black and blue at injection site.

   MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
8. 2021-05-21
   Health check-in — day 21, dose 1

   Feeling: Fair

   Adult check-in
9. 2021-06-03
   Dose 2 — Moderna
10. 2021-06-11
    Survey response — day 7, dose 2

    MedDRA: Unevaluable event — Feeling: Fair · Site: Pain, Redness, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional

    Free text: Sceduled dermatology appt at VA. Scheduled appt with a pain mgt Dr.

    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
11. 2021-06-11
    Report sent to call center — day 7, dose 2

    Get care from a doctor or other healthcare professional

    1 call case(s)
12. 2021-06-19
    Health check-in — day 14, dose 2

    Feeling: Fair

    Adult check-in
13. 2021-06-22
    Call 1 — Left Voicemail
14. 2021-12-04
    Survey response — 6 months, dose 2

    MedDRA: COVID-19 pneumonia, Chronic obstructive pulmonary disease, Computerised tomogram abnormal, Pulmonary fibrosis, Pulmonary mass, SARS-CoV-2 test, SARS-CoV-2 test negative — Feeling: Fair · Get care from a doctor or other healthcare professional

    Free text: Symptoms: Recent CT says scarred lungs from Covid pneumonia & COPD now & nodule right lung. Treated for pneumonia 8 wks ago. Tested neg for Covid test required by X-ray facility 11-21-2021 · Healthcare visit (other): Required 2 CT scans had to test for Covid because 1st one said I had Covid pneumonia cost me $77 each time & had to get Covid test each time before they would do X-ray

    MedDRA releases: 2024-11 · check-in free text available
15. 2021-12-04
    Report sent to call center — 6 months, dose 2

    Get care from a doctor or other healthcare professional

    1 call case(s)
16. 2021-12-06
    Call successful

    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
17. 2022-06-03
    Survey response — 12 months, dose 2

    MedDRA: COVID-19 pneumonia, Computerised tomogram abnormal, Pulmonary mass, Rash, SARS-CoV-2 test negative — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

    Free text: Symptoms: New skin rash. Increase in size of lung nodule. More frequent use of nasal spray but could be due to time of year in (b)(6). CT 10/05/2021 stated Covid pneumonia Covid test was negative prescribed 2 rounds of antibiotics repeat CT 11/24/2021 was ok · Healthcare visit (other): And VA for skin rash

    MedDRA releases: 2024-11 · check-in free text available
18. 2022-06-03
    Report sent to call center — 12 months, dose 2

    Get care from a doctor or other healthcare professional

    Telehealth, virtual health, or email health consultation · 1 call case(s)
19. 2022-06-06
    Call 1 — Left Voicemail