SN9-14061-66161

4 vaccinations 11 coded responses 40 check-ins 11 free-text entries 0 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 394 / MS
Registered: 2021-01-06

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

Registered dependents

GNS-20896-80594 Child or adolescent in my care · Female · 2022-06-29

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-01-04
Dose 1 — Moderna
2021-01-06
Registered in v-safe
2021-01-06
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Headache, Nausea, Pain, Pyrexia — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Yesterday I had Tmax 99.8F, body aches, fatigue, headache and nausea that have improved todau

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-01
Dose 2 — Moderna
2021-02-01
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

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

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-08
Survey response — day 7, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-15
Survey response — day 42, dose 2
MedDRA: Respiratory tract congestion, Sinus pain — Feeling: Fair

Free text: Congestion, sinus pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — 3 months, dose 2
MedDRA: Gastroenteritis — Feeling: Good · Be unable to work

Free text: Vital gateoenteritis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-02
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-29
Dose 3 — Moderna
2022-02-01
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-02-01
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-29
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-29
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in
2022-12-09
Dose 4 — Moderna
2022-12-09
Health check-in — day 0, dose 4
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2022-12-10
Survey response — days 1–6 daily, dose 4
MedDRA: Pre-existing disease — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site

Free text: Rash was present before injection

MedDRA releases: 2024-11 · check-in free text available
2022-12-11
Survey response — days 1–6 daily, dose 4
MedDRA: Pre-existing disease — Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection site

Free text: Rash present before injection

MedDRA releases: 2024-11 · check-in free text available
2022-12-12
Survey response — days 1–6 daily, dose 4
MedDRA: Unevaluable event — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Present before vaccine

MedDRA releases: 2024-11 · check-in free text available
2022-12-13
Survey response — days 1–6 daily, dose 4
MedDRA: Pre-existing disease — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Rash present before injection

MedDRA releases: 2024-11 · check-in free text available
2022-12-14
Survey response — days 1–6 daily, dose 4
MedDRA: Pre-existing disease — Feeling: Good · Headache, Rash, not including the immediate area around the injection site

Free text: Rash prior to injection

MedDRA releases: 2024-11 · check-in free text available
2022-12-15
Survey response — days 1–6 daily, dose 4
MedDRA: Pre-existing disease — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Rash prior to injection

MedDRA releases: 2024-11 · check-in free text available
2022-12-16
Survey response — day 7, dose 4
MedDRA: Pre-existing disease — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Rash present before injection

MedDRA releases: 2024-11 · check-in free text available
2022-12-23
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-12-30
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2023-01-06
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2023-01-13
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2023-01-20
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-03-10
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-06-09
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-04	Moderna
2	2021-02-01	Moderna
3	2021-10-29	Moderna	No
4	2022-12-09	Moderna	No

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-06

Systemic reaction (other): Yesterday I had Tmax 99.8F, body aches, fatigue, headache and nausea that have improved todau

Release 3 — day 7, dose 2

2021-02-08

Systemic reaction (other): Sore throat

Release 5 — day 42, dose 2

2021-03-15

Symptoms: Congestion, sinus pain

Release 8 — 3 months, dose 2

2021-05-03

Symptoms: Vital gateoenteritis

Release 12 — days 1–6 daily, dose 4

2022-12-10

Systemic reaction (other): Rash was present before injection

2022-12-11

Systemic reaction (other): Rash present before injection

2022-12-12

Systemic reaction (other): Present before vaccine

2022-12-13

Systemic reaction (other): Rash present before injection

2022-12-14

Systemic reaction (other): Rash prior to injection

2022-12-15

Systemic reaction (other): Rash prior to injection

Release 12 — day 7, dose 4

2022-12-16

Systemic reaction (other): Rash present before injection

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	Gastroenteritis	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Sinus pain	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pre-existing disease	·	·	✓
SRO	Pyrexia	✓	✓	✓
SRO	Unevaluable event	·	·	✓

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