4MJ-15994-23319

3 vaccinations 13 coded responses 23 check-ins 13 free-text entries 3 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 681 / NE
Registered: 2020-12-31

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

JX3-15471-37000 Child or adolescent in my care · Male · 2021-10-26

Timeline

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

2020-12-31
Registered in v-safe
2020-12-31
Dose 1 — Moderna
2020-12-31
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-01
Survey response — days 1–6 daily, dose 1
MedDRA: Lethargy, Lymphadenopathy, Pain in extremity, Self-medication — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Underarm swelling: all the checked symptoms above happened yesterday evening after 8pm. Took APAP and IBU on a rotating schedule through this morning. Now I feel much better, just mildly lethargic and my arm still hurts.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-02
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Good · Fatigue or tiredness

Free text: Just feeling really tired at the end of the day

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-07
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-23
Survey response — day 21, dose 1
MedDRA: Arthralgia, Pain in extremity — Feeling: Good

Free text: Increased achiness in legs/particularly left ankle

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Dose 2 — Moderna
2021-01-28
Survey response — day 0, dose 2
MedDRA: Feeling cold, Headache, Musculoskeletal stiffness — Feeling: Good · Site: Pain · Headache, Muscle or body aches

Free text: I have a slight headache, my neck feels stiff and am starting to feel cold. Im concerned it will be a rough night like it was for the first one.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Chills, Headache, Joint pains, Muscle or body aches · Be unable to work

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · Joint pains, Muscle or body aches

Adult check-in
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Myalgia — Feeling: Good · Joint pains, Muscle or body aches

Free text: Intermittent joint and muscle pain: more than usual.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — day 7, dose 2
MedDRA: Musculoskeletal stiffness — Feeling: Good

Free text: Stiffness in back of neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Survey response — day 28, dose 2
MedDRA: Headache, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Increased incidence of headaches since last vaccine: trying to rule out other causes. · Healthcare visit (other): Consult with dental professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-04
Survey response — day 35, dose 2
MedDRA: Headache — Feeling: Good

Free text: Continued increased frequency of headaches. Physician appointment pending,....

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Survey response — day 42, dose 2
MedDRA: Headache, Pruritus, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Body itching, still increased incidence of headaches · Healthcare visit (other): Pending appointment

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-29
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-29
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-04
Call 1 — Left Voicemail
2021-10-26
Dose 3 — Moderna
2021-10-26
Health check-in — day 0, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to work or attend school

Adult check-in
2021-10-27
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site pruritus, Injection site swelling, Somnolence — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I went back to bed for 2 hours about an hour after I got up. It was when I got up I noticed the swelling about the size of a golf ball in my arm. The injection site was itchy earlier. I'm hoping to get back in bed by 6pm. It's 4pm now.

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site induration, Injection site nodule, Injection site pain, Injection site pruritus — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Muscle or body aches

Free text: A large hard module at injection site is still present. It is not as tender and sometimes itches.

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site erythema, Injection site mass, Injection site pain — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Free text: Lump at injection site is getting smaller, still tender, still red.

MedDRA releases: 2024-11 · check-in free text available
2021-12-07
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-28
Survey response — 3 months, dose 3
MedDRA: Dry skin, Pruritus — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Itchy dry skin

MedDRA releases: 2024-11 · check-in free text available
2022-01-28
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-01
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-31	Moderna
2	2021-01-28	Moderna
3	2021-10-26	Moderna	No

Call center

3 call center cases

3 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-01

Systemic reaction (other): Underarm swelling: all the checked symptoms above happened yesterday evening after 8pm. Took APAP and IBU on a rotating schedule through this morning. Now I feel much better, just mildly lethargic and my arm still hurts.

2021-01-02

Systemic reaction (other): Just feeling really tired at the end of the day

Release 2 — day 21, dose 1

2021-01-23

Symptoms: Increased achiness in legs/particularly left ankle

Release 3 — day 0, dose 2

2021-01-28

Systemic reaction (other): I have a slight headache, my neck feels stiff and am starting to feel cold. Im concerned it will be a rough night like it was for the first one.

Release 3 — days 1–6 daily, dose 2

2021-02-03

Systemic reaction (other): Intermittent joint and muscle pain: more than usual.

Release 3 — day 7, dose 2

2021-02-06

Systemic reaction (other): Stiffness in back of neck

Release 4 — day 28, dose 2

2021-02-25

Symptoms: Increased incidence of headaches since last vaccine: trying to rule out other causes.

Healthcare visit (other): Consult with dental professional

Release 5 — day 35, dose 2

2021-03-04

Symptoms: Continued increased frequency of headaches. Physician appointment pending,....

Release 5 — day 42, dose 2

2021-03-13

Symptoms: Body itching, still increased incidence of headaches

Healthcare visit (other): Pending appointment

Release 10 — days 1–6 daily, dose 3

2021-10-27

Systemic reaction (other): I went back to bed for 2 hours about an hour after I got up. It was when I got up I noticed the swelling about the size of a golf ball in my arm. The injection site was itchy earlier. I'm hoping to get back in bed by 6pm. It's 4pm now.

2021-10-28

Systemic reaction (other): A large hard module at injection site is still present. It is not as tender and sometimes itches.

2021-10-29

Systemic reaction (other): Lump at injection site is getting smaller, still tender, still red.

Release 11 — 3 months, dose 3

2022-01-28

Symptoms: Itchy dry skin

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	Office visit	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Dry skin	·	·	✓
SD	Headache	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Pruritus	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling cold	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site erythema	·	·	✓
SRO	Injection site induration	·	·	✓
SRO	Injection site mass	·	·	✓
SRO	Injection site nodule	·	·	✓
SRO	Injection site pain	·	·	✓
SRO	Injection site pruritus	·	·	✓
SRO	Injection site swelling	·	·	✓
SRO	Lethargy	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Somnolence	·	·	✓

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