4XQ-18132-63139

3 vaccinations 4 coded responses 24 check-ins 4 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 981 / WA
Registered: 2021-01-25

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

2021-01-12
Dose 1 — Moderna
2021-01-25
Registered in v-safe
2021-01-26
Survey response — day 14, dose 1
MedDRA: Arthralgia, Chills, Fatigue, Influenza like illness, Myalgia — Feeling: Good · Be unable to do your normal daily activities

Free text: Flu-like symptoms for 5 days after vaccine, with generalized myalgia, fatigue, chills, some arthralgias, fatigue. Now fully resolved.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-09
Dose 2 — Moderna
2021-02-09
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Livedo reticularis, Nausea, Pre-existing disease, Raynaud's phenomenon, Reaction to previous exposure to any vaccine — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, 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: Except for the nausea, which is new, the signs and symptoms are similar to the first administration - just somewhat more severe. Also Raynauds and livido - more severe this morning than now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Livedo reticularis, Raynaud's phenomenon — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · 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: Raynauds; livido reticularis. Improved since yesterday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Muscle or body aches

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Muscle or body aches

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Muscle or body aches

Adult check-in
2021-02-16
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-11
Survey response — 3 months, dose 2
MedDRA: Condition aggravated, Fatigue, Laboratory test, Pre-existing disease, Raynaud's phenomenon, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Continuing Raynauds and chillblains. Sicca syndrome. Modest fatigue. · Healthcare visit (other): Lab testong

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-10
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-01
Dose 3 — Moderna
2021-10-23
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-29
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-05
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-12
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-31
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-01
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-05
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-01
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-12	Moderna
2	2021-02-09	Moderna
3	2021-10-01	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 2 — day 14, dose 1

2021-01-26

Symptoms: Flu-like symptoms for 5 days after vaccine, with generalized myalgia, fatigue, chills, some arthralgias, fatigue. Now fully resolved.

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): Except for the nausea, which is new, the signs and symptoms are similar to the first administration - just somewhat more severe. Also Raynauds and livido - more severe this morning than now.

2021-02-11

Systemic reaction (other): Raynauds; livido reticularis. Improved since yesterday.

Release 8 — 3 months, dose 2

2021-05-11

Symptoms: Continuing Raynauds and chillblains. Sicca syndrome. Modest fatigue.

Healthcare visit (other): Lab testong

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	Laboratory test	✓	✓	○
HCVO	Unevaluable event	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Condition aggravated	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Influenza like illness	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Raynaud's phenomenon	·	·	✓
SRO	Livedo reticularis	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Raynaud's phenomenon	✓	✓	✓
SRO	Reaction to previous exposure to any vaccine	✓	✓	✓

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