Z9K-27415-12134

5 vaccinations 7 coded responses 33 check-ins 7 free-text entries 0 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 600 / IL
Registered: 2021-02-13

Relationship: Self
Race: Other
Ethnicity: N/A

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-02-13
Registered in v-safe
2021-02-13
Dose 1 — Moderna
2021-02-13
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Joint pains

Adult check-in
2021-02-16
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction — Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Nausea

Free text: No, I just want to note that my symptoms come on every day in the middle of the afternoon.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — days 1–6 daily, dose 1
MedDRA: Pain — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Just shooting pains in my muscles & joints

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-20
Survey response — day 7, dose 1
MedDRA: Injection site pain — Feeling: Good · Fatigue or tiredness

Free text: I misread the first question about symptoms at my injection site: I only had pain at the injection site for the first two days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-13
Dose 2 — Moderna
2021-03-13
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: My symptoms increase in the mid-to-late afternoon.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-03-20
Health check-in — day 7, dose 2
Feeling: Good · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-03-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-10
Survey response — day 28, dose 2
MedDRA: Abdominal pain upper, Flatulence — Feeling: Good

Free text: I have had unexplainable recurring bouts of stomach cramping and gas.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-12
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-11
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-17
Dose 3 — Moderna
2022-03-14
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-22
Dose 4 — Moderna
2022-06-04
Survey response — day 7, dose 4
MedDRA: Adverse reaction — Feeling: Good · Site: Pain, Swelling

Free text: I want to note that I experienced these symptoms on 5/22/2022 when I received my second booster shot of the Moderna vaccine.Thank you for this follow up.

MedDRA releases: 2024-11 · check-in free text available
2022-06-05
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-12
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-19
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-26
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-08-21
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-19
Dose 5 — Moderna
2022-11-20
Survey response — 6 months, dose 4
MedDRA: Influenza — Feeling: Good · Be unable to do your normal daily activities

Free text: Unfortunately, even after getting my annual flu shot, I came down with a case of the flu, but I feel like I got lucky with its lack of severity and duration.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-13	Moderna
2	2021-03-13	Moderna
3	2021-11-17	Moderna	No
4	2022-05-22	Moderna	No
5	2022-10-19	Moderna	No

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-16

Systemic reaction (other): No, I just want to note that my symptoms come on every day in the middle of the afternoon.

2021-02-17

Systemic reaction (other): Just shooting pains in my muscles & joints

Release 4 — day 7, dose 1

2021-02-20

Systemic reaction (other): I misread the first question about symptoms at my injection site: I only had pain at the injection site for the first two days.

Release 5 — days 1–6 daily, dose 2

2021-03-14

Systemic reaction (other): My symptoms increase in the mid-to-late afternoon.

Release 7 — day 28, dose 2

2021-04-10

Symptoms: I have had unexplainable recurring bouts of stomach cramping and gas.

Release 11 — day 7, dose 4

2022-06-04

Systemic reaction (other): I want to note that I experienced these symptoms on 5/22/2022 when I received my second booster shot of the Moderna vaccine.Thank you for this follow up.

Release 12 — 6 months, dose 4

2022-11-20

Symptoms: Unfortunately, even after getting my annual flu shot, I came down with a case of the flu, but I feel like I got lucky with its lack of severity and duration.

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	Abdominal pain upper	✓	✓	✓
SD	Flatulence	✓	✓	✓
SD	Influenza	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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