4KR-17368-92681

2 vaccinations 10 coded responses 26 check-ins 10 free-text entries 1 call case

Sex: —
Age at first dose: 36-40
ZIP prefix: 841 / UT
Registered: 2021-03-05

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

2021-03-05
Registered in v-safe
2021-03-05
Dose 1 — Moderna
2021-03-05
Survey response — day 0, dose 1
MedDRA: Injection site warmth — Feeling: Good · Site: Pain, Swelling · Muscle or body aches

Free text: Injection area is warm to touch

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site bruising — Feeling: Good · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Bruising at the site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site bruising — Feeling: Good · Site: Pain, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Bruising at site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — days 1–6 daily, dose 1
MedDRA: Crying — Feeling: Good · Site: Pain · Joint pains

Free text: Weeping spell. I only mention it because my mom had a similar weeping spell a couple days after her first dose, also.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — days 1–6 daily, dose 1
MedDRA: Migraine — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: I have a migraine today, and all of my symptoms are migraine-related, but I get migraines once or twice a week and I seriously doubt its related to the shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-19
Survey response — day 14, dose 1
MedDRA: Injection site erythema — Feeling: Good

Free text: Hickey-like redness at injection site, like burst blood vessels under the skin, starting around day 8. No pain. Faded in a few days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-02
Dose 2 — Moderna
2021-04-02
Survey response — day 0, dose 2
MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches

Free text: Brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site bruising — Feeling: Good · Site: Pain, Redness, Swelling

Free text: Bruising at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Headache, Fatigue or tiredness

Adult check-in
2021-04-09
Health check-in — day 7, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-04-18
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-02
Survey response — 3 months, dose 2
MedDRA: Arrhythmia, Bradycardia, Tachycardia, Unevaluable event — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Cardiac arrhythmia tachycardia and bradycardia unlikely to be related to the vaccine. · Healthcare visit (other): 48-hour holter monitor. Results not yet back.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-02
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-07-07
Call 1 — Left Voicemail
2021-07-07
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-01
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-04-02
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-05	Moderna
2	2021-04-02	Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 5 — day 0, dose 1

2021-03-05

Systemic reaction (other): Injection area is warm to touch

Release 5 — days 1–6 daily, dose 1

2021-03-06

Systemic reaction (other): Bruising at the site.

2021-03-07

Systemic reaction (other): Bruising at site

2021-03-08

Systemic reaction (other): Weeping spell. I only mention it because my mom had a similar weeping spell a couple days after her first dose, also.

2021-03-09

Systemic reaction (other): I have a migraine today, and all of my symptoms are migraine-related, but I get migraines once or twice a week and I seriously doubt its related to the shot.

Release 6 — day 14, dose 1

2021-03-19

Symptoms: Hickey-like redness at injection site, like burst blood vessels under the skin, starting around day 8. No pain. Faded in a few days.

Release 6 — day 0, dose 2

2021-04-02

Systemic reaction (other): Brain fog

Release 6 — days 1–6 daily, dose 2

2021-04-03

Systemic reaction (other): Brain fog

2021-04-04

Systemic reaction (other): Bruising at injection site

Release 9 — 3 months, dose 2

2021-07-02

Symptoms: Cardiac arrhythmia tachycardia and bradycardia unlikely to be related to the vaccine.

Healthcare visit (other): 48-hour holter monitor. Results not yet back.

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	Unevaluable event	✓	✓	✓
SD	Arrhythmia	✓	✓	✓
SD	Bradycardia	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Tachycardia	✓	✓	✓
SRO	Crying	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Injection site warmth	✓	✓	✓
SRO	Migraine	✓	✓	✓

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