5Z4-23245-50618

2 vaccinations 6 coded responses 23 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 337 / FL
Registered: 2021-01-30

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

2021-01-30
Registered in v-safe
2021-01-30
Dose 1 — Moderna
2021-01-30
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-02
Survey response — days 1–6 daily, dose 1
MedDRA: Rash, Rash erythematous, Rash pruritic — Feeling: Good · Site: Pain, Swelling · Rash, not including the immediate area around the injection site

Free text: Red itchy rash started last night from neck to groin area, front and back. Took a benedryl and used cream on whole rash area called Triamcinolone Acetonide Cream USP 0.1% and again today and it's al.ost gone.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — days 1–6 daily, dose 1
MedDRA: Chest pain, Sleep disorder — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Last night after going to bed had severe pain in the bottom of my sternum. Really hurt for about 20 minutes. Got up and walked around until it stopped

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-07
Health check-in — day 7, dose 1
Feeling: Fair · None

Adult check-in
2021-02-15
Survey response — day 14, dose 1
MedDRA: Abdominal pain upper, Hospitalisation, Pancreatic cyst — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Cyst on pancreas, severe pain and in hospital 5 days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

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

Adult check-in
2021-02-27
Dose 2 — Moderna
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Rhinorrhoea — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Runny nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site rash, Rash — Feeling: Good · Site: Redness, Swelling, Itching

Free text: Rash at site 5"x5", rash on neck and under breasts

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Joint pains

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · None

Adult check-in
2021-03-06
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-30
Survey response — 3 months, dose 2
MedDRA: Bile duct stone, Biliary obstruction, Dysphagia, Hospitalisation, Immunisation reaction, Renal cyst, Ulcer — Feeling: Fair · 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: In hospital 10 days. Gi, bowel, ulcers, cysts on kidneys, stones in bile duct, blockage., hard to swallow.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-30
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-01
Call 1 — Left Voicemail
2021-08-28
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-02-27
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-30	Moderna
2	2021-02-27	Moderna

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-02

Systemic reaction (other): Red itchy rash started last night from neck to groin area, front and back. Took a benedryl and used cream on whole rash area called Triamcinolone Acetonide Cream USP 0.1% and again today and it's al.ost gone.

2021-02-03

Systemic reaction (other): Last night after going to bed had severe pain in the bottom of my sternum. Really hurt for about 20 minutes. Got up and walked around until it stopped

Release 4 — day 14, dose 1

2021-02-15

Symptoms: Cyst on pancreas, severe pain and in hospital 5 days.

Release 4 — days 1–6 daily, dose 2

2021-02-28

Systemic reaction (other): Runny nose

2021-03-02

Systemic reaction (other): Rash at site 5"x5", rash on neck and under breasts

Release 8 — 3 months, dose 2

2021-05-30

Symptoms: In hospital 10 days. Gi, bowel, ulcers, cysts on kidneys, stones in bile duct, blockage., hard to swallow.

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 upper	✓	✓	✓
SD	Bile duct stone	✓	✓	✓
SD	Biliary obstruction	✓	✓	✓
SD	Dysphagia	✓	✓	✓
SD	Hospitalisation	✓	✓	✓
SD	Immunisation reaction	✓	✓	✓
SD	Pancreatic cyst	✓	✓	✓
SD	Renal cyst	✓	✓	✓
SD	Ulcer	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Injection site rash	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash erythematous	✓	✓	✓
SRO	Rash pruritic	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Sleep disorder	✓	✓	✓

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