6RS-12184-86730

2 vaccinations 5 coded responses 26 check-ins 5 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 662 / KS
Registered: 2021-04-03

Relationship: Self
Race: Asian
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-04-03
Registered in v-safe
2021-04-03
Dose 1 — Moderna
2021-04-03
Health check-in — day 0, dose 1
Feeling: Fair · Site: Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

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

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness · Joint pains, Muscle or body aches

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-04-09
Survey response — days 1–6 daily, dose 1
MedDRA: Hypertension — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: blood pressure has spiked high.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — day 7, dose 1
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-17
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-24
Survey response — day 21, dose 1
MedDRA: Hypertension, Joint swelling, Peripheral swelling — Feeling: Fair · Be unable to do your normal daily activities

Free text: High blood pressure, extreme swelling in legs and ankles

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Dose 2 — Moderna
2021-05-01
Health check-in — day 0, dose 2
Feeling: Good · Chills, Nausea

Adult check-in
2021-05-02
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-05-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-05-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-05-08
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-30
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-06-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-02
Survey response — 3 months, dose 2
MedDRA: Hypertension — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: High blood pressure

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-30
Survey response — 6 months, dose 2
MedDRA: Anxiety, Blood pressure increased, Office visit, Pre-existing disease, Rheumatoid arthritis, Urticaria — Feeling: Poor · 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: Symptoms: Extremely high blood pressure, Severe RA. Flare . Anxiety and hives · Healthcare visit (other): Primary care and internal medicine specialist

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
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)
2021-11-03
Call 1 — Left Voicemail
2022-05-04
Survey response — 12 months, dose 2
MedDRA: Anxiety, Condition aggravated, Fibromyalgia, Hypertension, Malaise, Office visit, Pre-existing disease, Rash, Sjogren's syndrome, Swelling, Tremor — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Symptoms: Autoimmune issues have become uncontrollable, high blood pressure after the second shot, diagnosed with fibromagilya and Sjogren's, in November. Swelling and rashes constantly breaking out, tremors, extreme anxiety. Not doing well. · Healthcare visit (other): 12 week Chronic pain outpatient clinic

MedDRA releases: 2024-11 · check-in free text available
2022-05-04
Report sent to call center — 12 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-05-05
Call 1 — Could Not Reach Participant
2022-05-10
Call 2 — Could Not Reach Participant

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-03	Moderna
2	2021-05-01	Moderna

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-09

Systemic reaction (other): blood pressure has spiked high.

Release 7 — day 21, dose 1

2021-04-24

Symptoms: High blood pressure, extreme swelling in legs and ankles

Release 9 — 3 months, dose 2

2021-08-02

Symptoms: High blood pressure

Release 10 — 6 months, dose 2

2021-10-30

Symptoms: Extremely high blood pressure, Severe RA. Flare . Anxiety and hives

Healthcare visit (other): Primary care and internal medicine specialist

Release 11 — 12 months, dose 2

2022-05-04

Symptoms: Autoimmune issues have become uncontrollable, high blood pressure after the second shot, diagnosed with fibromagilya and Sjogren's, in November. Swelling and rashes constantly breaking out, tremors, extreme anxiety. Not doing well.

Healthcare visit (other): 12 week Chronic pain outpatient clinic

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	Office visit	·	·	✓
HCVO	Pre-existing disease	·	·	✓
SD	Anxiety	·	·	✓
SD	Blood pressure increased	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Fibromyalgia	·	·	✓
SD	Hypertension	✓	✓	✓
SD	Joint swelling	✓	✓	✓
SD	Malaise	·	·	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Rash	·	·	✓
SD	Rheumatoid arthritis	·	·	✓
SD	Sjogren's syndrome	·	·	✓
SD	Swelling	·	·	✓
SD	Tremor	·	·	✓
SD	Urticaria	·	·	✓
SRO	Hypertension	✓	✓	✓

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