4UR-12375-01420

Timeline

1. 2021-03-13
   Dose 1 — Moderna
2. 2021-04-12
   Dose 2 — Moderna
3. 2021-04-16
   Registered in v-safe
4. 2021-04-16
   Survey response — days 1–6 daily, dose 2

   MedDRA: Ear pain, Neck pain, Pruritus, Rhinalgia — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

   Free text: Neck pain, nose sore, ear sore, all on side of injection and itching on neck and forehead

   MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
5. 2021-04-17
   Survey response — days 1–6 daily, dose 2

   MedDRA: Oral pruritus, Pruritus, Rhinalgia — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

   Free text: Nose sore, mild itching around mouth and head, extreme itching on arm with injection.

   MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
6. 2021-04-19
   Survey response — day 7, dose 2

   MedDRA: Hyperhidrosis, Sleep disorder — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

   Free text: Extreme sweats when i fall to sleep. Then keeps me awake

   MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
7. 2021-04-26
   Health check-in — day 14, dose 2

   Feeling: Good

   Adult check-in
8. 2021-05-03
   Survey response — day 21, dose 2

   MedDRA: No adverse event — Feeling: Good

   Free text: Normal now.

   MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
9. 2021-05-10
   Survey response — day 28, dose 2

   MedDRA: Ear pain, Office visit, Tonsillolith — Feeling: Fair · Get care from a doctor or other healthcare professional

   Free text: Symptoms: Left Ear pain and left tonsil stone · Healthcare visit (other): Saw an ENT specialist

   MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
10. 2021-05-10
    Report sent to call center — day 28, dose 2

    Get care from a doctor or other healthcare professional

    1 call case(s)
11. 2021-07-12
    Survey response — 3 months, dose 2

    MedDRA: Injection site pain, Injection site swelling, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

    Free text: Symptoms: Pain, swelling, burning in arm injection received as well as pain on the same side, left upper chest. Also developed calcification spots in lungs and possible shingles symptoms (with no rash). · Healthcare visit (other): Already scheduled vusit with general practitioner.

    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
12. 2021-07-12
    Report sent to call center — 3 months, dose 2

    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

    1 call case(s)
13. 2021-07-16
    Call successful

    Does not wish to fill out VAERS report
14. 2021-10-11
    Survey response — 6 months, dose 2

    MedDRA: Pain in extremity, Pruritus — Feeling: Fair · Be unable to work or attend school, 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: Pain in left arm and severe itching both sides of mid/lower chest.

    MedDRA releases: 2024-11 · check-in free text available
15. 2021-10-11
    Report sent to call center — 6 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

    Outpatient clinic or urgent care clinic visit · 1 call case(s)
16. 2021-10-14
    Call 1 — Left Voicemail