5UD-26242-86078

3 vaccinations 9 coded responses 40 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 015 / MA
Registered: 2021-03-20

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

2021-03-20
Registered in v-safe
2021-03-20
Dose 1 — Moderna
2021-03-20
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Night sweats — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Full body DRENCHING night sweats that woke me up about 2 am

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · Fever · Fatigue or tiredness

Adult check-in
2021-03-24
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Axillary pain, Pain — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Arm pit / side of breast on same side where shot was is extremely sore. Like the Paine is radiating from my shoulder down

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary pain, Breast pain — Feeling: Good

Free text: Wicked severe ache in arm pit/side of breast on same side as shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-04
Survey response — day 14, dose 1
MedDRA: Injection site rash, Rash erythematous, Rash pruritic, Urticaria — Feeling: Good

Free text: Raised welt/rash at injection sight that was red and very itchy. It was about 2 inches in diameter, irregular shape. It showed up on the 8th day after injection and lasted 3 days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-18
Dose 2 — Moderna
2021-04-18
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness, Diarrhea

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-25
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-02
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-09
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-16
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-23
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-30
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-18
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-19
Survey response — 6 months, dose 2
MedDRA: Cough, Headache — Feeling: Fair

Free text: Headache Dry cough

MedDRA releases: 2024-11 · check-in free text available
2021-11-13
Dose 3 — Moderna
2021-11-13
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-11-14
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-11-15
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-11-16
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-11-17
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Itching · None

Adult check-in
2021-11-18
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-20
Health check-in — day 7, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-27
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-04
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-11
Survey response — day 28, dose 3
MedDRA: Headache — Feeling: Fair

Free text: HEADACHES

MedDRA releases: 2024-11 · check-in free text available
2021-12-18
Survey response — day 35, dose 3
MedDRA: Cough, Headache, Respiratory tract congestion — Feeling: Good

Free text: Headache Congestion Cough

MedDRA releases: 2024-11 · check-in free text available
2021-12-25
Survey response — day 42, dose 3
MedDRA: Cough, Respiratory tract congestion — Feeling: Fair

Free text: Cough Congestion

MedDRA releases: 2024-11 · check-in free text available
2022-02-12
Survey response — 3 months, dose 3
MedDRA: Blood pressure increased — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Super high BP 151/111

MedDRA releases: 2024-11 · check-in free text available
2022-02-12
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-16
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-20	Moderna
2	2021-04-18	Moderna
3	2021-11-13	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-22

Systemic reaction (other): Full body DRENCHING night sweats that woke me up about 2 am

2021-03-24

Systemic reaction (other): Arm pit / side of breast on same side where shot was is extremely sore. Like the Paine is radiating from my shoulder down

2021-03-25

Systemic reaction (other): Wicked severe ache in arm pit/side of breast on same side as shot.

Release 6 — day 14, dose 1

2021-04-04

Symptoms: Raised welt/rash at injection sight that was red and very itchy. It was about 2 inches in diameter, irregular shape. It showed up on the 8th day after injection and lasted 3 days.

Release 10 — 6 months, dose 2

2021-10-19

Symptoms: Headache Dry cough

Release 10 — day 28, dose 3

2021-12-11

Symptoms: HEADACHES

Release 10 — day 35, dose 3

2021-12-18

Symptoms: Headache Congestion Cough

Release 10 — day 42, dose 3

2021-12-25

Symptoms: Cough Congestion

Release 11 — 3 months, dose 3

2022-02-12

Symptoms: Super high BP 151/111

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 pressure increased	·	·	✓
SD	Cough	·	·	✓
SD	Headache	·	·	✓
SD	Injection site rash	✓	✓	✓
SD	Rash erythematous	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Urticaria	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Axillary pain	✓	✓	✓
SRO	Breast pain	✓	✓	✓
SRO	Night sweats	✓	✓	✓
SRO	Pain	✓	✓	✓

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