5R4-19731-25229

4 vaccinations 20 coded responses 46 check-ins 20 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 600 / IL
Registered: 2021-04-18

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

2021-04-17
Dose 1 — Moderna
2021-04-18
Registered in v-safe
2021-04-18
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Poor · Site: Pain, Itching · Fever · Headache, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Fair · Fever · Headache, Fatigue or tiredness, Nausea

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness, Nausea

Adult check-in
2021-04-24
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness, Nausea

Adult check-in
2021-05-01
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-15
Dose 2 — Moderna
2021-05-15
Survey response — day 0, dose 2
MedDRA: Unevaluable event — Feeling: Good

Free text: Literally got the vaccine 5 minutes ago

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Free text: sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good · Site: Pain · Headache

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good · Site: Pain · Headache

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain, Tinnitus — Feeling: Fair · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sore throat And increased tinnitus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-22
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-29
Survey response — day 14, dose 2
MedDRA: Tinnitus — Feeling: Good

Free text: Increased tinnitus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-12
Survey response — day 28, dose 2
MedDRA: Fatigue, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Feeling fatigue and headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-19
Survey response — day 35, dose 2
MedDRA: Arthralgia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Joint pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-26
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-08-14
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-11-14
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-12-07
Dose 3 — Moderna
2021-12-09
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Very large swelling in the lymph nodes in my underarm (same side as injection)

MedDRA releases: 2024-11 · check-in free text available
2021-12-11
Survey response — days 1–6 daily, dose 3
MedDRA: Oedema peripheral — Feeling: Fair · Site: Redness · Fever · Fatigue or tiredness

Free text: Swelling under armpit area

MedDRA releases: 2024-11 · check-in free text available
2021-12-12
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness · Fever · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-13
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fever · Joint pains, Fatigue or tiredness

Adult check-in
2021-12-14
Health check-in — day 7, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-12-21
Survey response — day 14, dose 3
MedDRA: Rash, Rash erythematous, Rash pruritic, Urticaria — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I have a red, welt-like rash, which is extremely painful and itchy, on my palms, torso, neck and head.

MedDRA releases: 2024-11 · check-in free text available
2021-12-28
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-01-04
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-11
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-18
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-08
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-09
Survey response — 6 months, dose 3
MedDRA: Office visit, Tendon pain — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Tendon pain in hips and legs · Healthcare visit (other): Doctor's office

MedDRA releases: 2024-11 · check-in free text available
2022-06-09
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

1 call case(s)
2022-06-10
Call 1 — Requested Callback
2022-06-13
Call 2 — Left Voicemail
2022-06-13
Callback requested for
11:00AM ET
2022-10-12
Dose 4 — Moderna
Co-administered: Flu
2022-10-17
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2022-10-18
Survey response — days 1–6 daily, dose 4
MedDRA: Cough, Nasal congestion — Feeling: Fair · Fatigue or tiredness

Free text: Cough and nasal congestion

MedDRA releases: 2024-11 · check-in free text available
2022-10-19
Survey response — day 7, dose 4
MedDRA: Cough, Nasal congestion — Feeling: Fair · Fever · Fatigue or tiredness

Free text: Cough and nasal congestion

MedDRA releases: 2024-11 · check-in free text available
2022-10-26
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-11-02
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-09
Survey response — day 28, dose 4
MedDRA: Multiple fractures — 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 · Emergency room or emergency department visit

Free text: I don't know if there's any connection, but just in case it's a common thing, I have had 2 incidents of broken bones in the last 10 weeks.

MedDRA releases: 2024-11 · check-in free text available
2022-11-09
Report sent to call center — day 28, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · 1 call case(s)
2022-11-10
Call 1 — Requested Callback
2022-11-15
Call 2 — Requested Callback
2022-11-16
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-11-18
Call 3 — Left Voicemail
2022-11-18
Callback requested for
12:00PM ET
2022-11-18
Call successful
Not applicable - Accidental Reporting
2022-11-18
Call successful
Not applicable - Accidental Reporting
2022-11-23
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-01-13
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2023-04-12
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-17	Moderna
2	2021-05-15	Moderna
3	2021-12-07	Moderna	No
4	2022-10-12	Moderna	Flu

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-18

Systemic reaction (other): Sore throat

2021-04-19

Systemic reaction (other): Sore throat

2021-04-20

Systemic reaction (other): Sore throat

2021-04-21

Systemic reaction (other): Sore throat

2021-04-22

Systemic reaction (other): Sore throat

Release 8 — day 0, dose 2

2021-05-15

Systemic reaction (other): Literally got the vaccine 5 minutes ago

Release 8 — days 1–6 daily, dose 2

2021-05-16

Systemic reaction (other): sore throat

2021-05-17

Systemic reaction (other): Sore throat

2021-05-18

Systemic reaction (other): Sore throat

2021-05-19

Systemic reaction (other): Sore throat And increased tinnitus

Release 8 — day 14, dose 2

2021-05-29

Symptoms: Increased tinnitus

Release 9 — day 28, dose 2

2021-06-12

Symptoms: Feeling fatigue and headache

Release 9 — day 35, dose 2

2021-06-19

Symptoms: Joint pain

Release 10 — days 1–6 daily, dose 3

2021-12-09

Systemic reaction (other): Very large swelling in the lymph nodes in my underarm (same side as injection)

2021-12-11

Systemic reaction (other): Swelling under armpit area

Release 10 — day 14, dose 3

2021-12-21

Symptoms: I have a red, welt-like rash, which is extremely painful and itchy, on my palms, torso, neck and head.

Release 12 — 6 months, dose 3

2022-06-09

Symptoms: Tendon pain in hips and legs

Healthcare visit (other): Doctor's office

Release 12 — days 1–6 daily, dose 4

2022-10-18

Systemic reaction (other): Cough and nasal congestion

Release 12 — day 7, dose 4

2022-10-19

Systemic reaction (other): Cough and nasal congestion

Release 12 — day 28, dose 4

2022-11-09

Symptoms: I don't know if there's any connection, but just in case it's a common thing, I have had 2 incidents of broken bones in the last 10 weeks.

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	Arthralgia	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Multiple fractures	·	·	✓
SD	Rash	·	·	✓
SD	Rash erythematous	·	·	✓
SD	Rash pruritic	·	·	✓
SD	Tendon pain	·	·	✓
SD	Tinnitus	✓	✓	✓
SD	Urticaria	·	·	✓
SRO	Cough	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Nasal congestion	·	·	✓
SRO	Oedema peripheral	·	·	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Tinnitus	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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