CNS-13293-95510

3 vaccinations 12 coded responses 27 check-ins 11 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 126 / NY
Registered: 2021-01-04

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-01-02
Dose 1 — Moderna
2021-01-04
Registered in v-safe
2021-01-04
Survey response — days 1–6 daily, dose 1
MedDRA: Hypertension — Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Hypertension

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-04
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-01-09
Survey response — day 7, dose 1
MedDRA: Burning sensation — Feeling: Fair

Free text: Burning sensation left ankle

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-23
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-01-30
Dose 2 — Moderna
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activities

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains

Adult check-in
2021-02-06
Health check-in — day 7, dose 2
Feeling: Fair · Headache · Be unable to do your normal daily activities

Adult check-in
2021-02-13
Survey response — day 14, dose 2
MedDRA: Limb discomfort, Pain in extremity — Feeling: Fair

Free text: My lower extremities feel heavy and ache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-02-27
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-06
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-13
Survey response — day 42, dose 2
MedDRA: Pain in extremity — Feeling: Fair

Free text: Left leg hurts

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — 3 months, dose 2
MedDRA: Anaemia, Dyspnoea, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Anemia and shortness of breath · Healthcare visit (other): Iron transfusion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-09
Call 1 — Left Voicemail
2021-08-02
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-01-04
Dose 3 — Moderna
2022-01-05
Survey response — days 1–6 daily, dose 3
MedDRA: Anaemia, Hypertension, Pregnancy — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Free text: Anemia, Hypertension, pregnancy

MedDRA releases: 2024-11 · check-in free text available
2022-01-06
Survey response — days 1–6 daily, dose 3
MedDRA: Hypertension, Pregnancy — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches

Free text: Pregnancy, anemia, hypertension

MedDRA releases: 2024-11 · check-in free text available
2022-01-07
Survey response — days 1–6 daily, dose 3
MedDRA: Anaemia, Hypertension, Oedema peripheral, Pregnancy — Feeling: Fair · Site: Swelling · Muscle or body aches

Free text: Anemia, hypertension, pregnancy, and swelling under armpit where shot was given

MedDRA releases: 2024-11 · check-in free text available
2022-01-09
Survey response — days 1–6 daily, dose 3
MedDRA: Anaemia, Hypertension, Pregnancy — Feeling: Fair

Free text: Anemia, pregnancy, and hypertension

MedDRA releases: 2024-11 · check-in free text available
2022-01-10
Survey response — days 1–6 daily, dose 3
MedDRA: Anaemia, Hypertension, Pregnancy — Feeling: Fair

Free text: Pregnancy, anemia, and hypertension

MedDRA releases: 2024-11 · check-in free text available
2022-01-11
Survey response — day 7, dose 3
MedDRA: Anaemia, Hypertension, Pregnancy — Feeling: Fair · Abdominal pain

Free text: Anemia, hypertension, pregnancy

MedDRA releases: 2024-11 · check-in free text available
2022-02-03
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-04-06
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2023-01-06
Survey response — 12 months, dose 3
MedDRA: Back pain, Bone pain — Feeling: Fair · Be unable to work or attend school

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-02	Moderna
2	2021-01-30	Moderna
3	2022-01-04	Moderna	No

Call center

2 call center cases

1 unsuccessful · 1 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-04

Systemic reaction (other): Hypertension

Release 1 — day 7, dose 1

2021-01-09

Systemic reaction (other): Burning sensation left ankle

Release 4 — day 14, dose 2

2021-02-13

Symptoms: My lower extremities feel heavy and ache

Release 5 — day 42, dose 2

2021-03-13

Symptoms: Left leg hurts

Release 8 — 3 months, dose 2

2021-05-03

Symptoms: Anemia and shortness of breath

Healthcare visit (other): Iron transfusion

Release 10 — days 1–6 daily, dose 3

2022-01-05

Systemic reaction (other): Anemia, Hypertension, pregnancy

2022-01-06

Systemic reaction (other): Pregnancy, anemia, hypertension

2022-01-07

Systemic reaction (other): Anemia, hypertension, pregnancy, and swelling under armpit where shot was given

2022-01-09

Systemic reaction (other): Anemia, pregnancy, and hypertension

2022-01-10

Systemic reaction (other): Pregnancy, anemia, and hypertension

Release 10 — day 7, dose 3

2022-01-11

Systemic reaction (other): Anemia, hypertension, pregnancy

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	Unevaluable event	✓	✓	✓
SD	Anaemia	✓	✓	✓
SD	Back pain	·	·	✓
SD	Bone pain	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Limb discomfort	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SRO	Anaemia	·	·	✓
SRO	Burning sensation	✓	✓	✓
SRO	Hypertension	✓	✓	✓
SRO	Oedema peripheral	·	·	✓
SRO	Pregnancy	·	·	✓

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