6NG-21816-04942

4 vaccinations 5 coded responses 37 check-ins 5 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 382 / TN
Registered: 2021-03-19

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

2021-03-11
Dose 1 — Moderna
2021-03-19
Registered in v-safe
2021-03-19
Survey response — day 7, dose 1
MedDRA: Back pain, Condition aggravated, Joint swelling, Pre-existing disease — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: over the last week I have had, in addition to the above, swelling in my joints and swelling in my ankles, pain in my back near my kidneys, more heart arhythmia events than normal (periventricular contractions)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-01
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-08
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-04-16
Dose 2 — Moderna
2021-04-16
Health check-in — day 0, dose 2
Feeling: Poor · Site: Pain, Redness, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Fatigue or tiredness

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

Adult check-in
2021-04-23
Health check-in — day 7, dose 2
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-04-30
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-14
Survey response — day 28, dose 2
MedDRA: Cough, Malaise — Feeling: Good

Free text: Strong malaise and odd mild cough for several days but then felt better. No fever. I did not have COVID test.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-28
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-16
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-15
Survey response — 6 months, dose 2
MedDRA: Bacterial infection, Ear infection, Office visit, SARS-CoV-2 test negative, Sinusitis — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Bacterial Sinus infection and ear infection Was COVID negative per test at physicians office

MedDRA releases: 2024-11 · check-in free text available
2021-10-15
Report sent to call center — 6 months, 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-20
Call 1 — Left Voicemail
2021-11-19
Dose 3 — Moderna
2021-11-25
Survey response — days 1–6 daily, dose 3
MedDRA: Contusion, Disorientation, Dizziness, Erythema, Fatigue, Immediate post-injection reaction, Pain, Pruritus, Swelling, Urticaria — Feeling: Fair · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Some faintness about 10 min after the shot, then mild disorientation. Fatigue within one hour was moderate. One day following shot swelling redness pain and itching golf ball sized welt with small bruise at top

MedDRA releases: 2024-11 · check-in free text available
2021-11-28
Health check-in — day 7, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-12-03
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-12-10
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-26
Survey response — day 35, dose 3
MedDRA: Arthralgia, Fatigue, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headache, Joint pain and fatigue

MedDRA releases: 2024-11 · check-in free text available
2021-12-31
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-18
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-10-08
Dose 4 — Moderna
2022-10-09
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-10
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-11
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-12
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2022-10-13
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2022-10-15
Health check-in — day 7, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-10-23
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-29
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-05
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-12
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-19
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-11	Moderna
2	2021-04-16	Moderna
3	2021-11-19	Moderna	No
4	2022-10-08	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 5 — day 7, dose 1

2021-03-19

Systemic reaction (other): over the last week I have had, in addition to the above, swelling in my joints and swelling in my ankles, pain in my back near my kidneys, more heart arhythmia events than normal (periventricular contractions)

Release 8 — day 28, dose 2

2021-05-14

Symptoms: Strong malaise and odd mild cough for several days but then felt better. No fever. I did not have COVID test.

Release 10 — 6 months, dose 2

2021-10-15

Symptoms: Bacterial Sinus infection and ear infection Was COVID negative per test at physicians office

Release 10 — days 1–6 daily, dose 3

2021-11-25

Systemic reaction (other): Some faintness about 10 min after the shot, then mild disorientation. Fatigue within one hour was moderate. One day following shot swelling redness pain and itching golf ball sized welt with small bruise at top

Release 10 — day 35, dose 3

2021-12-26

Symptoms: Headache, Joint pain and fatigue

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	Arthralgia	·	·	✓
SD	Bacterial infection	·	·	✓
SD	Cough	✓	✓	✓
SD	Ear infection	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Malaise	✓	✓	✓
SD	Office visit	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sinusitis	·	·	✓
SRO	Back pain	✓	✓	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Contusion	·	·	✓
SRO	Disorientation	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Erythema	·	·	✓
SRO	Fatigue	·	·	✓
SRO	Immediate post-injection reaction	·	·	✓
SRO	Joint swelling	✓	✓	✓
SRO	Pain	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pruritus	·	·	✓
SRO	Swelling	·	·	✓
SRO	Urticaria	·	·	✓

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