4Z5-37419-83257

3 vaccinations 9 coded responses 29 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 337 / FL
Registered: 2021-03-03

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

2021-03-03
Registered in v-safe
2021-03-03
Dose 1 — Moderna
2021-03-03
Health check-in — day 0, dose 1
Feeling: Fair · None

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-10
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-17
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site pruritus, Vaccination site pain, Vaccination site rash, Vaccination site swelling — Feeling: Good

Free text: Swollen, red, sore arm at the vaccination site. It lasted for three days. On the 4th day it itched and rashy for a couple days and now it is fine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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: Good · Site: Swelling · None

Adult check-in
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Pain — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Back ache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Rash — Feeling: Fair · Site: Redness, Swelling · Fever · Rash, not including the immediate area around the injection site

Free text: Body rash. Neck, back, stomach, arms, shoulders

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: Insomnia, Lymphadenopathy, Oral herpes — Feeling: Fair · Site: Redness, Swelling · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Trouble sleeping, swollen gland in my neck, cold sore

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: Itching · None

Adult check-in
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Rash — Feeling: Fair · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Rash only on my chest now. Constant sneezing and head congestion. Not sure if it is the vaccine or something else

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — day 7, dose 2
MedDRA: Rhinorrhoea — Feeling: Good · Fatigue or tiredness

Free text: Constant runny nose

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

Adult check-in
2021-04-21
Survey response — day 21, dose 2
MedDRA: Fatigue — Feeling: Good

Free text: I'm still very tired.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — day 28, dose 2
Feeling: Good

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

Adult check-in
2021-05-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-29
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-05
Dose 3 — Moderna
2022-03-31
Survey response — 12 months, dose 2
MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Very achy joints

MedDRA releases: 2024-11 · check-in free text available
2022-04-08
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-07-06
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2023-01-07
Survey response — 12 months, dose 3
MedDRA: COVID-19, Surgery — 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 · Outpatient clinic or urgent care clinic visit, Hospitalization

MedDRA releases: 2024-11
2023-01-07
Report sent to call center — 12 months, dose 3
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 · Hospitalization · 1 call case(s)
2023-01-09
Call 1 — Left Voicemail
2023-01-10
Call 2 — Requested Callback
2023-01-18
Call 3 — Left Voicemail
2023-01-18
Callback requested for
10:30AM ET

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Moderna
2	2021-03-31	Moderna
3	2022-01-05	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 5 — day 14, dose 1

2021-03-17

Symptoms: Swollen, red, sore arm at the vaccination site. It lasted for three days. On the 4th day it itched and rashy for a couple days and now it is fine.

Release 6 — days 1–6 daily, dose 2

2021-04-01

Systemic reaction (other): Back ache

2021-04-03

Systemic reaction (other): Body rash. Neck, back, stomach, arms, shoulders

2021-04-04

Systemic reaction (other): Trouble sleeping, swollen gland in my neck, cold sore

Release 7 — days 1–6 daily, dose 2

2021-04-06

Systemic reaction (other): Rash only on my chest now. Constant sneezing and head congestion. Not sure if it is the vaccine or something else

Release 7 — day 7, dose 2

2021-04-07

Systemic reaction (other): Constant runny nose

Release 7 — day 21, dose 2

2021-04-21

Symptoms: I'm still very tired.

Release 11 — 12 months, dose 2

2022-03-31

Symptoms: Very achy joints

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	COVID-19	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Surgery	·	·	✓
SD	Vaccination site pain	✓	✓	✓
SD	Vaccination site rash	✓	✓	✓
SD	Vaccination site swelling	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Oral herpes	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓

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