5KY-46525-12883

3 vaccinations 8 coded responses 25 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 071 / NJ
Registered: 2021-03-09

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-03-08
Dose 1 — Moderna
2021-03-09
Registered in v-safe
2021-03-09
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: None

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-12
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary mass, Discomfort, Pain in extremity, Peripheral swelling — Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Free text: Unable to lay on left arm b/c pain and swelling & felt soft lump/bump in armpit against bones. Also pressure on left side of shoulder on left at base of neck.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary mass, Axillary pain — Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches

Free text: Left armpit feel like holding a ball in it and painful when arm pressed together and cannot lay on left shoulder/arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary pain, Musculoskeletal discomfort, Swelling — Feeling: Good · Site: Pain, Swelling · Muscle or body aches

Free text: Took Tylenol, swelling reduced and underarm pain reduced. Able to lay on l.shoulder with minimal discomfort.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · Muscle or body aches

Adult check-in
2021-03-22
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-05
Dose 2 — Moderna
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Eczema, Pruritus — Feeling: Good · Site: Itching

Free text: Latent eczema caused itching but not severe.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-12
Health check-in — day 7, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-04
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-19
Dose 3 — Moderna
2022-04-05
Survey response — 12 months, dose 2
MedDRA: Chest X-ray abnormal, Chest discomfort, Dyspnoea, Pulmonary mass — Feeling: Good

Free text: Pressure in my chest, sometimes causes shortness in breath. Cardiologist did many test; not heart. Chest X-rays showed small nodule , not uncommon. Recent health dept clinics' exam shows alls well. Maybe long Covid-19??

MedDRA releases: 2024-11 · check-in free text available
2022-07-20
Survey response — 6 months, dose 3
MedDRA: COVID-19, Chest X-ray abnormal, Chest discomfort, Nodule, Office visit, Respiratory tract congestion — Feeling: Good · 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: Symptoms: Intermittent pressure in my chest since 2nd Covid-19 event last year. Cardiologists many tests found nothing, except occasional congestion but no cold. Chest X-ray showed nodule but not unusual. It persists and worse if I am laying down and around · Healthcare visit (other): No primary Dr so went to the health Dept clinic, nurse practitioner gave option for X-ray but not happy w/service.

MedDRA releases: 2024-11 · check-in free text available
2022-07-20
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-07-21
Call successful
Not applicable - Accidental Reporting
2023-01-26
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-08	Moderna
2	2021-04-05	Moderna
3	2022-01-19	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-09

Systemic reaction (other): No

2021-03-10

Systemic reaction (other): None

2021-03-12

Systemic reaction (other): Unable to lay on left arm b/c pain and swelling & felt soft lump/bump in armpit against bones. Also pressure on left side of shoulder on left at base of neck.

2021-03-13

Systemic reaction (other): Left armpit feel like holding a ball in it and painful when arm pressed together and cannot lay on left shoulder/arm.

2021-03-14

Systemic reaction (other): Took Tylenol, swelling reduced and underarm pain reduced. Able to lay on l.shoulder with minimal discomfort.

Release 7 — days 1–6 daily, dose 2

2021-04-08

Systemic reaction (other): Latent eczema caused itching but not severe.

Release 11 — 12 months, dose 2

2022-04-05

Symptoms: Pressure in my chest, sometimes causes shortness in breath. Cardiologist did many test; not heart. Chest X-rays showed small nodule , not uncommon. Recent health dept clinics' exam shows alls well. Maybe long Covid-19??

Release 12 — 6 months, dose 3

2022-07-20

Symptoms: Intermittent pressure in my chest since 2nd Covid-19 event last year. Cardiologists many tests found nothing, except occasional congestion but no cold. Chest X-ray showed nodule but not unusual. It persists and worse if I am laying down and around cut off by CDC

Healthcare visit (other): No primary Dr so went to the health Dept clinic, nurse practitioner gave option for X-ray but not happy w/service.

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	·	·	✓
SD	Chest discomfort	·	·	✓
SD	Chest X-ray abnormal	·	·	✓
SD	COVID-19	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Nodule	·	·	✓
SD	Office visit	·	·	✓
SD	Pulmonary mass	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SRO	Axillary mass	✓	✓	✓
SRO	Axillary pain	✓	✓	✓
SRO	Discomfort	✓	✓	✓
SRO	Eczema	✓	✓	✓
SRO	Musculoskeletal discomfort	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Swelling	✓	✓	✓

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