5L2-11034-02543

2 vaccinations 7 coded responses 25 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 391 / MS
Registered: 2021-03-08

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

2021-03-08
Registered in v-safe
2021-03-08
Dose 1 — Moderna
2021-03-08
Survey response — day 0, dose 1
MedDRA: Skin burning sensation — Feeling: Good · Fatigue or tiredness

Free text: About 25 mins after shot forearm was kind of burning sensation to top of skin but stopped about an hour after shot

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

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Chest discomfort — Feeling: Good

Free text: Chest feels kinda slight pressure

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 · None

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
2021-04-05
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-12
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-19
Survey response — day 14, dose 2
MedDRA: Chills — Feeling: Good

Free text: Chills for about 12 hours under a blanket and a second Afghan blanket from about 6:30pm -6:30 am

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
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
Survey response — day 42, dose 2
MedDRA: Fatigue — Feeling: Good

Free text: A lot of Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-06
Survey response — 3 months, dose 2
MedDRA: Chest discomfort, Palpitations — Feeling: Good

Free text: Heart pulpitations tightening around my chest under breast occasionally

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-04
Survey response — 6 months, dose 2
MedDRA: Cardiac disorder — Feeling: Good

Free text: Heart pulpit actions at night

MedDRA releases: 2024-11 · check-in free text available
2022-04-05
Survey response — 12 months, dose 2
MedDRA: Blood glucose increased, Malaise — 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, Emergency room or emergency department visit

Free text: It was sue to my blood sugar going up to 500. Was I'll from 1 Jan 2022 through feb

MedDRA releases: 2024-11 · check-in free text available
2022-04-05
Report sent to call center — 12 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 · Emergency room or emergency department visit · 1 call case(s)
2022-04-06
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-08	Moderna
2	2021-04-05	Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 5 — day 0, dose 1

2021-03-08

Systemic reaction (other): About 25 mins after shot forearm was kind of burning sensation to top of skin but stopped about an hour after shot

Release 5 — days 1–6 daily, dose 1

2021-03-14

Systemic reaction (other): Chest feels kinda slight pressure

Release 7 — day 14, dose 2

2021-04-19

Symptoms: Chills for about 12 hours under a blanket and a second Afghan blanket from about 6:30pm -6:30 am

Release 8 — day 42, dose 2

2021-05-17

Symptoms: A lot of Fatigue

Release 9 — 3 months, dose 2

2021-07-06

Symptoms: Heart pulpitations tightening around my chest under breast occasionally

Release 10 — 6 months, dose 2

2021-10-04

Symptoms: Heart pulpit actions at night

Release 11 — 12 months, dose 2

2022-04-05

Symptoms: It was sue to my blood sugar going up to 500. Was I'll from 1 Jan 2022 through feb

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	Blood glucose increased	·	·	✓
SD	Cardiac disorder	·	·	✓
SD	Chest discomfort	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Malaise	·	·	✓
SD	Palpitations	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Skin burning sensation	✓	✓	✓

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