6WB-19610-06679

2 vaccinations 6 coded responses 17 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 199 / DE
Registered: 2021-01-19

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

2021-01-17
Dose 1 — Moderna
2021-01-19
Registered in v-safe
2021-01-19
Survey response — days 1–6 daily, dose 1
MedDRA: Chills, Flushing, Headache, Injection site pain, Lethargy, Pain, Self-medication, Somnolence — Feeling: Good · Site: Pain

Free text: I want to report on my symptoms yesterday, 1/18. I had very sore arm/injection site, chills, aches, lethargic, ache at base of skull, flushed face/ no temp, slight headache on sides of head, slept during the day. Took tylenol at dinner, felt normal within an hour. It never returned.

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: General symptom — Feeling: Good

Free text: I want to report my symptoms from first 24 hours after injection, but system would not let me in.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-07
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-13
Dose 2 — Moderna
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Back disorder, Chills, Physiotherapy — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Chills actually threw my back out and i needed to go to PT to get some relief. · Healthcare visit (other): Physical Therapy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling · Headache

Adult check-in
2021-02-19
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Oedema peripheral, Physiotherapy, Tremor — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Swelling in arm pit of injection arm. Still working on relaxing lower back muscles (from shaking w chills) in PT. · Healthcare visit (other): Physical Therapy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-20
Survey response — day 7, dose 2
MedDRA: Back pain, Chills, Myalgia — Feeling: Good

Free text: Sure back muscles, still recovering from shivering from chills

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-06
Survey response — day 21, dose 2
MedDRA: Facial pain, Headache, Lymphadenopathy — Feeling: Good

Free text: Severe head/face ache on 3/3. (Don't know if this was associated w shot or not)Still have swollen glands under armpit of arm where shot was given. (This is from shot)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-02
Call 1 — Could Not Reach Participant
2021-08-05
Call 2 — Could Not Reach Participant
2021-08-14
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-13
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-17	Moderna
2	2021-02-13	Moderna

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 — days 1–6 daily, dose 1

2021-01-19

Systemic reaction (other): I want to report on my symptoms yesterday, 1/18. I had very sore arm/injection site, chills, aches, lethargic, ache at base of skull, flushed face/ no temp, slight headache on sides of head, slept during the day. Took tylenol at dinner, felt normal within an hour. It never returned.

2021-01-23

Systemic reaction (other): I want to report my symptoms from first 24 hours after injection, but system would not let me in.

Release 4 — days 1–6 daily, dose 2

2021-02-15

Systemic reaction (other): Chills actually threw my back out and i needed to go to PT to get some relief.

Healthcare visit (other): Physical Therapy

2021-02-19

Systemic reaction (other): Swelling in arm pit of injection arm. Still working on relaxing lower back muscles (from shaking w chills) in PT.

Healthcare visit (other): Physical Therapy

Release 4 — day 7, dose 2

2021-02-20

Systemic reaction (other): Sure back muscles, still recovering from shivering from chills

Release 5 — day 21, dose 2

2021-03-06

Symptoms: Severe head/face ache on 3/3. (Don't know if this was associated w shot or not)Still have swollen glands under armpit of arm where shot was given. (This is from shot)

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	Physiotherapy	✓	✓	✓
SD	Facial pain	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SRO	Back disorder	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Flushing	✓	✓	✓
SRO	General symptom	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Lethargy	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Oedema peripheral	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Somnolence	✓	✓	✓
SRO	Tremor	✓	✓	✓

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