5WW-19585-76252

2 vaccinations 13 coded responses 26 check-ins 13 free-text entries 0 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 481 / MI
Registered: 2021-01-05

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-01-05
Registered in v-safe
2021-01-05
Dose 1 — Moderna
2021-01-05
Health check-in — day 0, dose 1
Feeling: Good · Site: Swelling · None

Adult check-in
2021-01-06
Survey response — days 1–6 daily, dose 1
MedDRA: Injected limb mobility decreased, Injection site nodule — Feeling: Fair · Site: Pain, Swelling

Free text: Difficulty lifting my right arm and a knot at the injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site nodule — Feeling: Good · Site: Pain

Free text: Knot remains at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site nodule, Pain — Feeling: Good · Site: Pain

Free text: Knot at injection site pain with lifting

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-09
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site nodule — Feeling: Good · Site: Pain

Free text: Knot at injection site;

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-10
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Pain

Free text: Pain at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-11
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site nodule, Injection site pain — Feeling: Good · Site: Pain

Free text: Pain almost minimum but knot remains at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Survey response — day 7, dose 1
MedDRA: Unevaluable event — Feeling: Good · Site: Pain

Free text: Symptoms reported previously unchanged

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-20
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-26
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-02
Dose 2 — Moderna
2021-02-02
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Injected limb mobility decreased, Injection site nodule — Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: A knot at the injection site; inability to raise arm where injection given

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site nodule — Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Knot at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema, Injection site nodule — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Be unable to do your normal daily activities

Free text: Knot at injection site and spreading redness and Erythema

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema — Feeling: Good · Site: Pain, Redness, Swelling, Itching

Free text: Spreading redness!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-02-09
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-02-16
Survey response — day 14, dose 2
MedDRA: Injection site pain, Injection site pruritus — Feeling: Good

Free text: Injection site pain and itching persists right arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-04
Survey response — 3 months, dose 2
MedDRA: Abdominal pain, Vomiting — Feeling: Good

Free text: Abdominal pain and vomiting episodes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-03
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-04
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-05	Moderna
2	2021-02-02	Moderna

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-06

Systemic reaction (other): Difficulty lifting my right arm and a knot at the injection site.

2021-01-07

Systemic reaction (other): Knot remains at injection site

2021-01-08

Systemic reaction (other): Knot at injection site pain with lifting

2021-01-09

Systemic reaction (other): Knot at injection site;

2021-01-10

Systemic reaction (other): Pain at injection site

2021-01-11

Systemic reaction (other): Pain almost minimum but knot remains at injection site

Release 1 — day 7, dose 1

2021-01-12

Systemic reaction (other): Symptoms reported previously unchanged

Release 3 — days 1–6 daily, dose 2

2021-02-03

Systemic reaction (other): A knot at the injection site; inability to raise arm where injection given

2021-02-04

Systemic reaction (other): Knot at injection site

2021-02-05

Systemic reaction (other): Knot at injection site and spreading redness and Erythema

2021-02-06

Systemic reaction (other): Spreading redness!

Release 4 — day 14, dose 2

2021-02-16

Symptoms: Injection site pain and itching persists right arm

Release 8 — 3 months, dose 2

2021-05-04

Symptoms: Abdominal pain and vomiting episodes

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	Abdominal pain	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Vomiting	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Injected limb mobility decreased	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site nodule	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Mobility decreased	○	○	○
SRO	Pain	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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