4GZ-19705-18797

3 vaccinations 10 coded responses 39 check-ins 10 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 600 / IL
Registered: 2021-02-18

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

2021-02-18
Registered in v-safe
2021-02-18
Dose 1 — Moderna
2021-02-18
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site paraesthesia — Feeling: Good · Site: Pain

Free text: Some tingling on the shoulder above and below the injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Survey response — days 1–6 daily, dose 1
MedDRA: Paraesthesia — Feeling: Good · Site: Itching

Free text: Intermittent tingling of the shoulder, to the neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Survey response — days 1–6 daily, dose 1
MedDRA: Paraesthesia — Feeling: Fair · Site: Itching · Headache

Free text: Tingling in shoulder

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Itching · Muscle or body aches

Adult check-in
2021-02-24
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site paraesthesia, Paraesthesia — Feeling: Fair · Site: Pain, Itching · Chills, Muscle or body aches · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Tingling from mid-upper arm to the neck in the arm that had the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-25
Survey response — day 7, dose 1
MedDRA: Paraesthesia, Pruritus — Feeling: Fair · Site: Pain, Itching · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Tingling and itching in my shoulder, down my arm and up into my neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-04
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-18
Dose 2 — Moderna
2021-03-18
Health check-in — day 0, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-17
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-01
Call 1 — Could Not Reach Participant
2021-09-07
Call 2 — Left Voicemail
2021-09-16
Survey response — 6 months, dose 2
MedDRA: Asthma, Bacterial infection, Pre-existing disease, Sinusitis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Asthma exacerbation and bacterial sinus infection

MedDRA releases: 2024-11 · check-in free text available
2021-09-16
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-17
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-09
Dose 3 — Moderna
2021-11-10
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Itching · Headache

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

Adult check-in
2021-11-12
Survey response — days 1–6 daily, dose 3
MedDRA: Discomfort — Feeling: Good · Site: Pain, Itching

Free text: Underarm discomfort in injected arm

MedDRA releases: 2024-11 · check-in free text available
2021-11-13
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain — Feeling: Good · Site: Pain, Itching

Free text: Mild underarm soreness in injected arm

MedDRA releases: 2024-11 · check-in free text available
2021-11-14
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain — Feeling: Good · Site: Itching

Free text: Continued mild soreness in the armpit

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-11-16
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-23
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-30
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-07
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-15
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-21
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-08
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-10
Survey response — 6 months, dose 3
MedDRA: Asthma, Nasopharyngitis, Pre-existing disease, SARS-CoV-2 test negative — Feeling: Fair

Free text: Asthma exacerbation from a cold. Covid test negative.

MedDRA releases: 2024-11 · check-in free text available
2022-11-11
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-18	Moderna
2	2021-03-18	Moderna
3	2021-11-09	Moderna	No

Call center

3 call center cases

1 successful · 2 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-19

Systemic reaction (other): Some tingling on the shoulder above and below the injection site.

2021-02-20

Systemic reaction (other): Intermittent tingling of the shoulder, to the neck

2021-02-21

Systemic reaction (other): Tingling in shoulder

2021-02-24

Systemic reaction (other): Tingling from mid-upper arm to the neck in the arm that had the vaccine

Release 4 — day 7, dose 1

2021-02-25

Systemic reaction (other): Tingling and itching in my shoulder, down my arm and up into my neck

Release 9 — 6 months, dose 2

2021-09-16

Symptoms: Asthma exacerbation and bacterial sinus infection

Release 10 — days 1–6 daily, dose 3

2021-11-12

Systemic reaction (other): Underarm discomfort in injected arm

2021-11-13

Systemic reaction (other): Mild underarm soreness in injected arm

2021-11-14

Systemic reaction (other): Continued mild soreness in the armpit

Release 11 — 6 months, dose 3

2022-05-10

Symptoms: Asthma exacerbation from a cold. Covid test negative.

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	Asthma	·	·	✓
SD	Bacterial infection	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sinusitis	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Discomfort	·	·	✓
SRO	Injection site paraesthesia	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Pruritus	✓	✓	✓

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