59Z-21240-84868

2 vaccinations 7 coded responses 23 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 064 / CT
Registered: 2021-01-05

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

Timeline

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

2021-01-04
Dose 1 — Moderna
2021-01-05
Registered in v-safe
2021-01-05
Survey response — days 1–6 daily, dose 1
MedDRA: Dysgeusia, Ear discomfort, Pruritus — Feeling: Good · Site: Pain, Redness · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Metallic taste in mouth, ears popping/almost ringing, itchy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-05
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Chills, Fatigue or tiredness

Adult check-in
2021-01-08
Survey response — days 1–6 daily, dose 1
MedDRA: Ear discomfort, Tinnitus — Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Ringing/pressure in ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-11
Survey response — day 7, dose 1
MedDRA: Chapped lips, Dizziness, Lip erythema, Lip swelling, Oral discomfort — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: DK if I remembered to mention that on day 2 my lips were burning and chapped and red/swollen at the edges. Also had weird random brief dizzy spells for a couple days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Survey response — day 14, dose 1
MedDRA: Mobility decreased, Pain in extremity — Feeling: Good

Free text: Not worse, but arm still feels like torn muscle. Cant twist, lift.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Survey response — day 21, dose 1
MedDRA: Mobility decreased, Pain, Pain in extremity — Feeling: Good

Free text: Not worse but arm pain cant lift, twist, pain radiates down arm and circular on upper arm ,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Dose 2 — Moderna
2021-02-02
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Fair · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

Free text: Itchy all over

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-07
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

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

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

Adult check-in
2021-02-28
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-07
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-02
Survey response — 3 months, dose 2
MedDRA: Office visit, Physiotherapy, Pre-existing disease, Reaction to previous exposure to any vaccine — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: This is not new. I am in PT for my arm. I have had pain and loss of function since my first dose. · Healthcare visit (other): Orthopedic and PT

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
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)
2021-06-11
Call 1 — Left Voicemail
2021-08-01
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-31
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-04	Moderna
2	2021-01-31	Moderna

Call center

3 call center cases

1 unsuccessful · 2 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-05

Systemic reaction (other): Metallic taste in mouth, ears popping/almost ringing, itchy

2021-01-08

Systemic reaction (other): Ringing/pressure in ears

Release 1 — day 7, dose 1

2021-01-11

Systemic reaction (other): DK if I remembered to mention that on day 2 my lips were burning and chapped and red/swollen at the edges. Also had weird random brief dizzy spells for a couple days

Release 2 — day 14, dose 1

2021-01-18

Symptoms: Not worse, but arm still feels like torn muscle. Cant twist, lift.

Release 2 — day 21, dose 1

2021-01-25

Symptoms: Not worse but arm pain cant lift, twist, pain radiates down arm and circular on upper arm ,

Release 3 — days 1–6 daily, dose 2

2021-02-02

Systemic reaction (other): Itchy all over

Release 8 — 3 months, dose 2

2021-05-02

Symptoms: This is not new. I am in PT for my arm. I have had pain and loss of function since my first dose.

Healthcare visit (other): Orthopedic and PT

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	Physiotherapy	✓	✓	✓
SD	Mobility decreased	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Physiotherapy	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Reaction to previous exposure to any vaccine	✓	✓	✓
SRO	Chapped lips	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Ear discomfort	✓	✓	✓
SRO	Lip erythema	✓	✓	✓
SRO	Lip swelling	✓	✓	✓
SRO	Oral discomfort	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Tinnitus	✓	✓	✓

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