62J-47339-02218

3 vaccinations 9 coded responses 40 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 190 / PA
Registered: 2021-01-22

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

Timeline

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

2021-01-22
Registered in v-safe
2021-01-22
Dose 1 — Moderna
2021-01-22
Survey response — day 0, dose 1
MedDRA: Axillary pain, Injection site pain — Feeling: Good

Free text: Slight Pain on inside armpit only on the same arm where I got the shot.it also burned slightly.Now it feels much better just slightly sore feeling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary pain — Feeling: Good · Muscle or body aches

Free text: I ticked off muscle and body ache so I would have option to write this -(Slight pain close to my underarm on same arm I had the shot. Off and on

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Nausea

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-05
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-19
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-27
Dose 2 — Moderna
2021-02-27
Survey response — day 0, dose 2
MedDRA: Injection site pain — Feeling: Good

Free text: Slight burning at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling cold — Feeling: Fair · Site: Pain, Itching

Free text: Feeling cold

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: Fair · Site: Pain · Joint pains, Fatigue or tiredness

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Good · Fatigue or tiredness

Free text: No

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

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

Adult check-in
2021-03-06
Health check-in — day 7, dose 2
Feeling: Good · None

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: Fair

Adult check-in
2021-03-27
Survey response — day 28, dose 2
MedDRA: Headache, Pain — Feeling: Good

Free text: A pain on left side of my head its like a radiating pain from the back end to the front but still just on the left side dull not sharp.It happened a couple times but not everyday.I do not know if it has anything to do with the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-10
Survey response — day 42, dose 2
MedDRA: Herpes zoster, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Shingkes · Healthcare visit (other): Drs appointment

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-29
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-28
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-20
Dose 3 — Moderna
2021-12-21
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-12-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-12-23
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-27
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-01-03
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-10
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-17
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-24
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-31
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-17
Call 1 — Left Voicemail
2022-03-21
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-20
Survey response — 6 months, dose 3
MedDRA: Abdominal distension, Gastrooesophageal reflux disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Swollen extended stomach acid reflux.

MedDRA releases: 2024-11 · check-in free text available
2022-06-20
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-21
Call 2 — Left Voicemail
2022-06-21
Call 1 — Left Voicemail
2022-12-22
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Moderna
2	2021-02-27	Moderna
3	2021-12-20	Moderna	No

Call center

2 call center cases

2 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-22

Systemic reaction (other): Slight Pain on inside armpit only on the same arm where I got the shot.it also burned slightly.Now it feels much better just slightly sore feeling

Release 2 — days 1–6 daily, dose 1

2021-01-23

Systemic reaction (other): I ticked off muscle and body ache so I would have option to write this -(Slight pain close to my underarm on same arm I had the shot. Off and on

2021-01-27

Systemic reaction (other): No

Release 4 — day 0, dose 2

2021-02-27

Systemic reaction (other): Slight burning at injection site

Release 4 — days 1–6 daily, dose 2

2021-02-28

Systemic reaction (other): Feeling cold

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): No

Release 6 — day 28, dose 2

2021-03-27

Symptoms: A pain on left side of my head its like a radiating pain from the back end to the front but still just on the left side dull not sharp.It happened a couple times but not everyday.I do not know if it has anything to do with the vaccine

Release 7 — day 42, dose 2

2021-04-10

Symptoms: Shingkes

Healthcare visit (other): Drs appointment

Release 12 — 6 months, dose 3

2022-06-20

Symptoms: Swollen extended stomach acid reflux.

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	Unevaluable event	✓	✓	✓
SD	Abdominal distension	·	·	✓
SD	Gastrooesophageal reflux disease	·	·	✓
SD	Headache	✓	✓	✓
SD	Herpes zoster	✓	✓	✓
SD	Pain	✓	✓	✓
SRO	Axillary pain	✓	✓	✓
SRO	Feeling cold	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	No adverse event	✓	✓	✓

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