PFW-34023-21520

4 vaccinations 6 coded responses 40 check-ins 5 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 967 / HI
Registered: 2021-04-29

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

2021-04-01
Dose 1 — Moderna
2021-04-29
Registered in v-safe
2021-04-29
Dose 2 — Moderna
2021-04-29
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-30
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Pains on my left shoulder at the injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-05-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-05-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-05-06
Health check-in — day 7, dose 2
Feeling: Good · Joint pains, Diarrhea

Adult check-in
2021-05-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-27
Health check-in — day 28, dose 2
Feeling: Good

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

Adult check-in
2021-06-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-28
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-29
Dose 3 — Moderna
2021-10-29
Survey response — day 0, dose 3
MedDRA: Visual impairment — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Weak eyesight

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Chills, Headache

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache

Adult check-in
2021-11-05
Health check-in — day 7, dose 3
Feeling: Good · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-11-12
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-26
Survey response — day 28, dose 3
MedDRA: Headache, Sleep disorder — Feeling: Good

Free text: Headache and irregular sleep

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-12
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-28
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-29
Survey response — 6 months, dose 3
MedDRA: Change of bowel habit, Constipation — Feeling: Good · 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, Emergency room or emergency department visit

Free text: Constipation, change in bowel movement; was mild for the past year, but got worse after pregnancy

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
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

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
2022-05-03
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-27
Dose 4 — Moderna
Co-administered: Flu
2022-10-29
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-29
Survey response — 12 months, dose 3
MedDRA: Hypoaesthesia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Numbing left shoulders and armpit

MedDRA releases: 2024-11 · check-in free text available
2022-10-30
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-10-31
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-01
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-03
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-11-10
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-11-17
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-24
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-12-01
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-12-08
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2023-01-28
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-04-27
Survey response — 6 months, dose 4
MedDRA: Blepharospasm — Feeling: Fair

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-01	Moderna
2	2021-04-29	Moderna
3	2021-10-29	Moderna	No
4	2022-10-27	Moderna	Flu

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 8 — days 1–6 daily, dose 2

2021-04-30

Systemic reaction (other): Pains on my left shoulder at the injection site.

Release 10 — day 0, dose 3

2021-10-29

Systemic reaction (other): Weak eyesight

Release 10 — day 28, dose 3

2021-11-26

Symptoms: Headache and irregular sleep

Release 11 — 6 months, dose 3

2022-04-29

Symptoms: Constipation, change in bowel movement; was mild for the past year, but got worse after pregnancy

Release 12 — 12 months, dose 3

2022-10-29

Symptoms: Numbing left shoulders and armpit

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	Blepharospasm	·	·	✓
SD	Change of bowel habit	·	·	✓
SD	Constipation	·	·	✓
SD	Headache	·	·	✓
SD	Hypoaesthesia	·	·	✓
SD	Sleep disorder	·	·	✓
SRO	Injection site pain	✓	✓	✓
SRO	Visual impairment	·	·	✓

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