6PJ-51949-39997

3 vaccinations 7 coded responses 39 check-ins 7 free-text entries 0 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 145 / NY
Registered: 2021-01-06

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

2021-01-06
Registered in v-safe
2021-01-06
Dose 1 — Moderna
2021-01-06
Survey response — day 0, dose 1
MedDRA: Paraesthesia, Piloerection — Feeling: Good · Site: Pain, Swelling

Free text: Tingling and goosebumps in left arm (site of injection)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-01-08
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Fatigue, Myalgia — Feeling: Good · Site: Pain, Swelling

Free text: The evening of 1/7/21 - I felt fatigued, had myalgia and arthralgia (cleared up the following morning). Thai occurred after submitting my vsafe entry for that day.

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

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-15
Health check-in — day 7, dose 1
Feeling: Good · Site: Swelling, Itching · None

Adult check-in
2021-01-21
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-27
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-03
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-10
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-02-12
Dose 2 — Moderna
2021-02-12
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · None

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-14
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-13
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-13
Dose 3 — Moderna
2022-01-15
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Lymphadenopathy — Feeling: Good · Site: Pain

Free text: Axillary pain on same side as injection. Probably related to local lymphadenopathy.

MedDRA releases: 2024-11 · check-in free text available
2022-01-16
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain — Feeling: Good

Free text: Left axillary pain (same side as injection)

MedDRA releases: 2024-11 · check-in free text available
2022-01-17
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Pain — Feeling: Good

Free text: Left axillary pain. Worse when lifting arm above head

MedDRA releases: 2024-11 · check-in free text available
2022-01-18
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Lymphadenopathy — Feeling: Good

Free text: Slight arm put pain from lymphadenopathy

MedDRA releases: 2024-11 · check-in free text available
2022-01-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-01-20
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-01-27
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-02-03
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-02-10
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-02-19
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-26
Survey response — day 42, dose 3
MedDRA: Nasopharyngitis, Oropharyngeal pain — Feeling: Fair

Free text: A cold with a sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-04-17
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-07-14
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2023-01-13
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-06	Moderna
2	2021-02-12	Moderna
3	2022-01-13	Moderna	No

Free text

Release 1 — day 0, dose 1

2021-01-06

Systemic reaction (other): Tingling and goosebumps in left arm (site of injection)

Release 1 — days 1–6 daily, dose 1

2021-01-08

Systemic reaction (other): The evening of 1/7/21 - I felt fatigued, had myalgia and arthralgia (cleared up the following morning). Thai occurred after submitting my vsafe entry for that day.

Release 10 — days 1–6 daily, dose 3

2022-01-15

Systemic reaction (other): Axillary pain on same side as injection. Probably related to local lymphadenopathy.

2022-01-16

Systemic reaction (other): Left axillary pain (same side as injection)

2022-01-17

Systemic reaction (other): Left axillary pain. Worse when lifting arm above head

2022-01-18

Systemic reaction (other): Slight arm put pain from lymphadenopathy

Release 11 — day 42, dose 3

2022-02-26

Symptoms: A cold with a sore throat

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	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Axillary pain	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Myalgia	✓	✓	✓
SRO	Pain	·	·	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Piloerection	✓	✓	✓

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