PNF-15885-78786

4 vaccinations 4 coded responses 48 check-ins 4 free-text entries 0 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 930 / CA
Registered: 2021-01-09

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

6E2-25595-87226 Child or adolescent in my care · Female · 2022-07-15

NDW-21556-45835 Child or adolescent in my care · Male · 2022-07-15

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-01-08
Dose 1 — Moderna
2021-01-09
Registered in v-safe
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

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

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Diarrhea

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary pain, Lymph node pain, Lymphadenopathy — Feeling: Fair

Free text: Left armpit lymph node swollen and painful.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Survey response — day 7, dose 1
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good

Free text: Swollen, painful lymph node in injection side armpit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Health check-in — day 14, dose 1
Feeling: Good

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

Adult check-in
2021-02-05
Dose 2 — Moderna
2021-02-05
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · None

Adult check-in
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site warmth — Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Free text: Heat at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches

Adult check-in
2021-02-12
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-19
Survey response — day 14, dose 2
MedDRA: Injection site swelling — Feeling: Good

Free text: Injection site underarm is still swollen.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-13
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-06
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-28
Dose 3 — Moderna
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness

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

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-11-05
Health check-in — day 7, dose 3
Feeling: Good · None

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

Adult check-in
2021-11-20
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-25
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-02
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-11
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-27
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-30
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-27
Dose 4 — Moderna
2022-10-28
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in
2022-10-28
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-29
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-30
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-31
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-11-01
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-11-02
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

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: Poor

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
2022-12-02
Health check-in — day 35, dose 4
Feeling: Good

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

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

Adult check-in
2023-04-27
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-08	Moderna
2	2021-02-05	Moderna
3	2021-10-28	Moderna	No
4	2022-10-27	Moderna	No

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-14

Systemic reaction (other): Left armpit lymph node swollen and painful.

Release 2 — day 7, dose 1

2021-01-15

Systemic reaction (other): Swollen, painful lymph node in injection side armpit

Release 3 — days 1–6 daily, dose 2

2021-02-06

Systemic reaction (other): Heat at injection site

Release 4 — day 14, dose 2

2021-02-19

Symptoms: Injection site underarm is still swollen.

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	Injection site swelling	✓	✓	✓
SRO	Axillary pain	○	✓	○
SRO	Injection site warmth	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓

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