5SQ-24132-59589

2 vaccinations 5 coded responses 26 check-ins 5 free-text entries 1 call case

Sex: Female
Age at first dose: 36-40
ZIP prefix: 441 / OH
Registered: 2021-06-10

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

2021-06-10
Registered in v-safe
2021-06-10
Dose 1 — Moderna
2021-06-10
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-06-11
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-06-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-06-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-06-14
Survey response — days 1–6 daily, dose 1
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain

Free text: Swollen and painful lymph nodes under the left arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-06-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-06-17
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness, Nausea, Diarrhea, Rash, not including the immediate area around the injection site

Adult check-in
2021-06-24
Survey response — day 14, dose 1
MedDRA: Rash, Rash pruritic, Self-medication — Feeling: Good

Free text: Itchy rash on my chest, back and arms. I applied hydrocortisone and took a benadryl and was ok

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-01
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-07-08
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-07-12
Dose 2 — Moderna
2021-07-12
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-07-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school

Adult check-in
2021-07-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-07-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling, Itching · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-07-16
Survey response — days 1–6 daily, dose 2
MedDRA: Exfoliative rash, Rash erythematous, Rash pruritic, Self-medication — Feeling: Fair · Site: Itching · Headache, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site

Free text: Red itchy scaly rash areas only on the left side of my body. This is the same side that I received my vaccination. I'm applying hydrocortisone for now before I go see a doctor.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Nausea, Rash, not including the immediate area around the injection site

Adult check-in
2021-07-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Headache, Rash, not including the immediate area around the injection site

Adult check-in
2021-07-19
Health check-in — day 7, dose 2
Feeling: Good · Headache, Rash, not including the immediate area around the injection site

Adult check-in
2021-07-26
Survey response — day 14, dose 2
MedDRA: Pruritus, Rash — 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 · Telehealth, virtual health, or email health consultation

Free text: Rash and itching (severe)

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-26
Report sent to call center — day 14, 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

1 call case(s)
2021-08-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-08-04
Call 1 — Left Voicemail
2021-08-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-08-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-08-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-10-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-07-14
Survey response — 12 months, dose 2
MedDRA: Peripheral swelling, Urticaria — Feeling: Fair · Be unable to do your normal daily activities

Free text: The arm that I received my vaccination remains swollen. I broke out in hives and continued to do so for several months.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-06-10	Moderna
2	2021-07-12	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 9 — days 1–6 daily, dose 1

2021-06-14

Systemic reaction (other): Swollen and painful lymph nodes under the left arm

Release 9 — day 14, dose 1

2021-06-24

Symptoms: Itchy rash on my chest, back and arms. I applied hydrocortisone and took a benadryl and was ok

Release 9 — days 1–6 daily, dose 2

2021-07-16

Systemic reaction (other): Red itchy scaly rash areas only on the left side of my body. This is the same side that I received my vaccination. I'm applying hydrocortisone for now before I go see a doctor.

Release 9 — day 14, dose 2

2021-07-26

Symptoms: Rash and itching (severe)

Release 12 — 12 months, dose 2

2022-07-14

Symptoms: The arm that I received my vaccination remains swollen. I broke out in hives and continued to do so for several months.

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	Peripheral swelling	·	·	✓
SD	Pruritus	✓	·	✓
SD	Rash	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Urticaria	·	·	✓
SRO	Exfoliative rash	✓	·	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Rash erythematous	✓	·	✓
SRO	Rash pruritic	✓	·	✓
SRO	Self-medication	✓	·	✓

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