4NH-12065-54111

2 vaccinations 7 coded responses 17 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 076 / NJ
Registered: 2021-03-10

Relationship: Self
Race: American Indian or Alaska Native
Ethnicity: Hispanic or Latino

Timeline

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

2021-03-03
Dose 1 — Moderna
2021-03-10
Registered in v-safe
2021-03-10
Survey response — day 7, dose 1
MedDRA: Dizziness — Feeling: Fair · Fatigue or tiredness

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-24
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-31
Dose 2 — Moderna
2021-03-31
Health check-in — day 0, dose 2
Feeling: Poor · Site: Pain · Headache, Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Joint pains, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Itching · Fever · Chills, Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Itching · Joint pains, Fatigue or tiredness, Diarrhea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Itching · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Itching · Headache, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-04-05
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-07
Health check-in — day 7, dose 2
Feeling: Fair · Site: Itching · Fever · Headache, Joint pains, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-14
Survey response — day 14, dose 2
MedDRA: Fatigue, Rash — Feeling: Poor · Be unable to do your normal daily activities

Free text: Fatigue and the rash has come back

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — day 21, dose 2
MedDRA: Arthralgia, Headache, Self-medication — Feeling: Poor · Be unable to do your normal daily activities

Free text: I continue to have rashes on my arms my neck and today my face. Have to use Benadryl. Have had headache and joint pain all day.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Survey response — day 28, dose 2
MedDRA: Rash — Feeling: Poor · Be unable to do your normal daily activities

Free text: I continue to have a rash and n my body. It is debilitating and Benadryl doesnt always work

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Survey response — day 35, dose 2
MedDRA: Pre-existing disease, Rash — Feeling: Poor · Be unable to do your normal daily activities

Free text: The rash I have been suffering from has moved from my back, arms and torso to my knees as well. My ears itch all the time and allergy medication is not working. Its truly debilitating

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Survey response — day 42, dose 2
MedDRA: Dizziness, Ear pruritus, Fatigue, Headache, Rash — Feeling: Fair · Be unable to do your normal daily activities

Free text: The rash I have been experiencing continues to come out in new places and my issues with the itchy ears make it difficult to go about normal life. Have an appointment with an allergist for next week. I am also experiencing headaches fatigue dizzines

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-01
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Rash — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Joint pain and rashes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-29
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-03-18
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Moderna
2	2021-03-31	Moderna

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 — day 7, dose 1

2021-03-10

Systemic reaction (other): Dizziness

Release 7 — day 14, dose 2

2021-04-14

Symptoms: Fatigue and the rash has come back

Release 7 — day 21, dose 2

2021-04-21

Symptoms: I continue to have rashes on my arms my neck and today my face. Have to use Benadryl. Have had headache and joint pain all day.

Release 8 — day 28, dose 2

2021-04-28

Symptoms: I continue to have a rash and n my body. It is debilitating and Benadryl doesnt always work

Release 8 — day 35, dose 2

2021-05-05

Symptoms: The rash I have been suffering from has moved from my back, arms and torso to my knees as well. My ears itch all the time and allergy medication is not working. Its truly debilitating

Release 8 — day 42, dose 2

2021-05-12

Symptoms: The rash I have been experiencing continues to come out in new places and my issues with the itchy ears make it difficult to go about normal life. Have an appointment with an allergist for next week. I am also experiencing headaches fatigue dizzines cut off by CDC

Release 9 — 3 months, dose 2

2021-07-01

Symptoms: Joint pain and rashes

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	Arthralgia	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Ear pruritus	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Self-medication	✓	✓	✓
SRO	Dizziness	✓	✓	✓

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