Y3A-15366-95121

2 vaccinations 7 coded responses 18 check-ins 7 free-text entries 0 call cases

Sex: —
Age at first dose: 36-40
ZIP prefix: 995 / AK
Registered: 2021-04-01

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-03-22
Dose 1 — Moderna
2021-04-01
Registered in v-safe
2021-04-01
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain, Redness, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-05
Survey response — day 14, dose 1
MedDRA: Arthralgia, Fatigue, Malaise, Neck pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Soreness and pain in neck and shoulder (opposite arm from the one where the vaccine was administered). General malaise and tiredness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-19
Dose 2 — Moderna
2021-04-19
Survey response — day 0, dose 2
MedDRA: Paraesthesia oral — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness

Free text: Slight tingling feeling around lips since the vaccine this afternoon.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-26
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain

Adult check-in
2021-05-03
Survey response — day 14, dose 2
MedDRA: Pyrexia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Symptoms similar to food poisoning (with an unclear source) begining last night/early this morning. Low-grade fever.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Survey response — day 21, dose 2
MedDRA: Arthralgia, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue and joint pain. Persistent chilblain(s) on one toe on my left foot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Survey response — day 28, dose 2
MedDRA: Chillblains, Pain in extremity, Weight bearing difficulty — Feeling: Fair · Be unable to do your normal daily activities

Free text: Consistent chilblains on middle toe of left foot. Painful and difficult to put pressure/weight on.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Survey response — day 35, dose 2
MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Continued issue with middle toe on left foot. Additional pain in jointsfeet, ankles, knees, etc.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Survey response — day 42, dose 2
MedDRA: Arthralgia, Pre-existing disease — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Same ongoing issue with swollen toe/chilblains on left foot. (Not infected or broken, but painful and causes difficulty when walking.) Joint pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-21
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-20
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-22	Moderna
2	2021-04-19	Moderna

Free text

Release 6 — day 14, dose 1

2021-04-05

Symptoms: Soreness and pain in neck and shoulder (opposite arm from the one where the vaccine was administered). General malaise and tiredness.

Release 7 — day 0, dose 2

2021-04-19

Systemic reaction (other): Slight tingling feeling around lips since the vaccine this afternoon.

Release 8 — day 14, dose 2

2021-05-03

Symptoms: Symptoms similar to food poisoning (with an unclear source) begining last night/early this morning. Low-grade fever.

Release 8 — day 21, dose 2

2021-05-10

Symptoms: Fatigue and joint pain. Persistent chilblain(s) on one toe on my left foot.

Release 8 — day 28, dose 2

2021-05-19

Symptoms: Consistent chilblains on middle toe of left foot. Painful and difficult to put pressure/weight on.

Release 8 — day 35, dose 2

2021-05-26

Symptoms: Continued issue with middle toe on left foot. Additional pain in jointsfeet, ankles, knees, etc.

Release 8 — day 42, dose 2

2021-06-02

Symptoms: Same ongoing issue with swollen toe/chilblains on left foot. (Not infected or broken, but painful and causes difficulty when walking.) Joint pain.

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	Arthralgia	✓	✓	✓
SD	Chillblains	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Weight bearing difficulty	✓	✓	✓
SRO	Paraesthesia oral	✓	✓	✓

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