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4JA-16855-23598

1 vaccination 6 coded responses 13 check-ins 6 free-text entries 1 call case
Sex
Female
Age at first dose
41-45
ZIP prefix
724 / AR
Registered
2021-03-15
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-15
    Registered in v-safe
  2. 2021-03-15
    Dose 1 — Moderna
  3. 2021-03-15
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-03-16
    Survey response — days 1–6 daily, dose 1
    MedDRA: Dizziness — Feeling: Good · Site: Pain
    Free text: Dizziness
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · None
    Adult check-in
  6. 2021-03-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Headache
    Adult check-in
  7. 2021-03-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-03-20
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-03-21
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-03-22
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  11. 2021-03-29
    Survey response — day 14, dose 1
    MedDRA: Injection site erythema, Injection site pain, Injection site pruritus, Injection site warmth — Feeling: Poor
    Free text: I have a very big red patch on my left arm were the injection site was and it itches and it hurts and it is warm to the touch.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-04-12
    Survey response — day 28, dose 1
    MedDRA: Cough, Dizziness, Fatigue, Feeling cold, Hypertension, Injection site pain, Paraesthesia — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Left arm pain where the injection was given that moves from lower arm to upper left shoulder to upper left chest. Tingling and cold sensation. Coughing. Dizziness. High blood pressure and fatigue.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-04-19
    Survey response — day 35, dose 1
    MedDRA: Burning sensation, Chest pain, Dizziness, Feeling cold, Feeling hot, Hypertension, Injection site warmth, Pain in extremity — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities
    Free text: Heat pain in upper left chest and pain in left arm followed with burning and cool sensations. High blood pressure and mild dizziness.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-04-26
    Survey response — day 42, dose 1
    MedDRA: Chest pain, Dizziness, Pain in extremity — Feeling: Poor · Be unable to work, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization
    Free text: Chest pain upper left. Left arm pain. Cool sensation that comes and goes. Dizziness
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-04-26
    Report sent to call center — day 42, dose 1
    Be unable to work · Get care from a doctor or other healthcare professional
    1 call case(s)
  16. 2021-06-14
    Survey response — 3 months, dose 1
    MedDRA: Fatigue, Paraesthesia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Left arm numbness and tingling with pain. Chest pain. Weak Tired and lightheaded. Coughing. Left leg and foot numbness and tingling.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-12-29

Vaccinations

DoseDateManufacturerCo-administered
12021-03-15Moderna

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 5 — days 1–6 daily, dose 1

2021-03-16

Systemic reaction (other): Dizziness

Release 6 — day 14, dose 1

2021-03-29

Symptoms: I have a very big red patch on my left arm were the injection site was and it itches and it hurts and it is warm to the touch.

Release 7 — day 28, dose 1

2021-04-12

Symptoms: Left arm pain where the injection was given that moves from lower arm to upper left shoulder to upper left chest. Tingling and cold sensation. Coughing. Dizziness. High blood pressure and fatigue.

Release 7 — day 35, dose 1

2021-04-19

Symptoms: Heat pain in upper left chest and pain in left arm followed with burning and cool sensations. High blood pressure and mild dizziness.

Release 8 — day 42, dose 1

2021-04-26

Symptoms: Chest pain upper left. Left arm pain. Cool sensation that comes and goes. Dizziness

Release 9 — 3 months, dose 1

2021-06-14

Symptoms: Left arm numbness and tingling with pain. Chest pain. Weak Tired and lightheaded. Coughing. Left leg and foot numbness and tingling.

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

FieldPreferred term2021-092023-042024-11
SDBurning sensation ✓ ✓ ✓
SDChest pain ✓ ✓ ✓
SDCough ✓ ✓ ✓
SDDizziness ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDFeeling cold ✓ ✓ ✓
SDFeeling hot ✓ ✓ ✓
SDHypertension ✓ ✓ ✓
SDInjection site erythema ✓ ✓ ✓
SDInjection site pain ✓ ✓ ✓
SDInjection site pruritus ✓ ✓ ✓
SDInjection site warmth ✓ ✓ ✓
SDPain in extremity ✓ ✓ ✓
SDParaesthesia ✓ ✓ ✓
SRODizziness ✓ ✓ ✓

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

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