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DVW-14537-81685

3 vaccinations 9 coded responses 41 check-ins 9 free-text entries 2 call cases
Sex
Female
Age at first dose
36-40
ZIP prefix
070 / NJ
Registered
2021-04-09
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-04-09
    Registered in v-safe
  2. 2021-04-09
    Dose 1 — Moderna
  3. 2021-04-09
    Health check-in — day 0, dose 1
    Feeling: Good · Site: Itching · Fatigue or tiredness
    Adult check-in
  4. 2021-04-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  5. 2021-04-11
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  6. 2021-04-12
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-04-13
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-04-14
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-04-15
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-04-16
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  11. 2021-04-23
    Survey response — day 14, dose 1
    MedDRA: Arthralgia, Muscle tightness — Feeling: Good
    Free text: Left shoulder/neck area muscle pain and tightness.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-05-02
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-05-07
    Dose 2 — Moderna
  14. 2021-05-07
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  15. 2021-05-08
    Survey response — days 1–6 daily, dose 2
    MedDRA: Decreased appetite, Hyperhidrosis, Oropharyngeal pain, Pain in extremity — Feeling: Poor · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Decreased appetite, sweats, sore throat, pain in my arm from elbow to
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-05-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-05-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-05-11
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-05-12
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-05-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  21. 2021-05-14
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  22. 2021-05-21
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-05-28
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-06-04
    Survey response — day 28, dose 2
    MedDRA: Fatigue, Headache, Oropharyngeal pain — Feeling: Good
    Free text: Headache, tiredness, and sore throat last Monday the 31st.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  25. 2021-06-13
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-06-18
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-08-06
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-11-05
    Survey response — 6 months, dose 2
    MedDRA: Abdominal pain upper, Pain, Urticaria, Vomiting projectile — Feeling: Good · 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: Hives on my hands, arms, thighs, calf, and ankle. Severe stomach pains and projectile vomiting incident, continued pains then sudden dissipation of pain.
    MedDRA releases: 2024-11 · check-in free text available
  29. 2021-11-05
    Report sent to call center — 6 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  30. 2021-11-09
  31. 2021-11-23
    Dose 3 — Moderna
  32. 2021-11-23
    Health check-in — day 0, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  33. 2021-11-24
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities
    Adult check-in
  34. 2021-11-24
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  35. 2021-11-25
    Survey response — days 1–6 daily, dose 3
    MedDRA: Breast pain — Feeling: Fair · Headache
    Free text: Mild soreness in left breast last 2 days (shot was in left arm).
    MedDRA releases: 2024-11 · check-in free text available
  36. 2021-11-26
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  37. 2021-11-27
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities
    Adult check-in
  38. 2021-11-28
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  39. 2021-11-29
    Survey response — days 1–6 daily, dose 3
    MedDRA: Oropharyngeal pain — Feeling: Good
    Free text: Sore throat
    MedDRA releases: 2024-11 · check-in free text available
  40. 2021-11-30
    Survey response — day 7, dose 3
    MedDRA: Oropharyngeal pain, Rhinorrhoea — Feeling: Fair
    Free text: Sore throat, runny nose
    MedDRA releases: 2024-11 · check-in free text available
  41. 2021-12-07
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  42. 2021-12-14
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  43. 2021-12-21
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  44. 2021-12-28
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  45. 2022-01-04
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  46. 2022-02-22
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  47. 2022-05-24
    Survey response — 6 months, dose 3
    MedDRA: COVID-19, Cough, Fatigue, Muscular weakness, Oropharyngeal pain — Feeling: Fair · 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: Covid positive: sore throat, fatigue, cough, muscle weakness
    MedDRA releases: 2024-11 · check-in free text available
  48. 2022-05-24
    Report sent to call center — 6 months, dose 3
    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)
  49. 2022-05-25
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  50. 2022-11-23
    Survey response — 12 months, dose 3
    MedDRA: Pregnancy — Feeling: Good
    Free text: Anemia during pregnancy.
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-04-09Moderna
22021-05-07Moderna
32021-11-23Moderna No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 7 — day 14, dose 1

2021-04-23

Symptoms: Left shoulder/neck area muscle pain and tightness.

Release 8 — days 1–6 daily, dose 2

2021-05-08

Systemic reaction (other): Decreased appetite, sweats, sore throat, pain in my arm from elbow to

Release 8 — day 28, dose 2

2021-06-04

Symptoms: Headache, tiredness, and sore throat last Monday the 31st.

Release 10 — 6 months, dose 2

2021-11-05

Symptoms: Hives on my hands, arms, thighs, calf, and ankle. Severe stomach pains and projectile vomiting incident, continued pains then sudden dissipation of pain.

Release 10 — days 1–6 daily, dose 3

2021-11-25

Systemic reaction (other): Mild soreness in left breast last 2 days (shot was in left arm).

2021-11-29

Systemic reaction (other): Sore throat

Release 10 — day 7, dose 3

2021-11-30

Systemic reaction (other): Sore throat, runny nose

Release 11 — 6 months, dose 3

2022-05-24

Symptoms: Covid positive: sore throat, fatigue, cough, muscle weakness

Release 12 — 12 months, dose 3

2022-11-23

Symptoms: Anemia during 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

FieldPreferred term2021-092023-042024-11
SDAbdominal pain upper · · ✓
SDArthralgia ✓ ✓ ✓
SDCough · · ✓
SDCOVID-19 · · ✓
SDFatigue ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDMuscle tightness ✓ ✓ ✓
SDMuscular weakness · · ✓
SDOropharyngeal pain ✓ ✓ ✓
SDPain · · ✓
SDPregnancy · · ✓
SDUrticaria · · ✓
SDVomiting projectile · · ✓
SROBreast pain · · ✓
SRODecreased appetite ✓ ✓ ✓
SROHyperhidrosis ✓ ✓ ✓
SROOropharyngeal pain ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SRORhinorrhoea · · ✓

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

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