6TP-32016-40587

2 vaccinations 7 coded responses 22 check-ins 7 free-text entries 0 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 530 / WI
Registered: 2021-01-05

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-01-05
Registered in v-safe
2021-01-05
Dose 1 — Moderna
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-01-12
Survey response — day 7, dose 1
MedDRA: Arthralgia — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site

Free text: I've had quite a bit of pain directly in the shoulder joint above the injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Survey response — day 14, dose 1
MedDRA: Injection site rash, Rash — Feeling: Fair

Free text: Rash on back of left hand and a couple spots near injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Survey response — day 21, dose 1
MedDRA: Rash, Rash pruritic, Self-medication — Feeling: Fair

Free text: Rash and itching have spread On both hands and chest but I put some caladryl on and they have gotten much better.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Dose 2 — Moderna
2021-02-02
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Nasal congestion — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Stuffy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia — Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Free text: Shoulder where I received the injection is very painful

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-02-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-09
Survey response — day 35, dose 2
MedDRA: Arthralgia — Feeling: Good

Free text: Joint pain increased ,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-04
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Dry skin, General physical health deterioration, Myalgia, Skin fissures, Skin haemorrhage — Feeling: Good · Be unable to do your normal daily activities

Free text: My health has deteriorated some with excruciating pain in my joints and muscles my skin is extremely extremely dry splitting and bleeding

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-03
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-05	Moderna
2	2021-02-02	Moderna

Free text

Release 1 — day 7, dose 1

2021-01-12

Systemic reaction (other): I've had quite a bit of pain directly in the shoulder joint above the injection site

Release 2 — day 14, dose 1

2021-01-19

Symptoms: Rash on back of left hand and a couple spots near injection site

Release 2 — day 21, dose 1

2021-01-27

Symptoms: Rash and itching have spread On both hands and chest but I put some caladryl on and they have gotten much better.

Release 3 — days 1–6 daily, dose 2

2021-02-04

Systemic reaction (other): Stuffy

2021-02-08

Systemic reaction (other): Shoulder where I received the injection is very painful

Release 5 — day 35, dose 2

2021-03-09

Symptoms: Joint pain increased ,

Release 8 — 3 months, dose 2

2021-05-04

Symptoms: My health has deteriorated some with excruciating pain in my joints and muscles my skin is extremely extremely dry splitting and bleeding

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	Dry skin	✓	✓	✓
SD	General physical health deterioration	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Skin fissures	✓	✓	✓
SD	Skin haemorrhage	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓

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