ZKE-22083-13683

2 vaccinations 8 coded responses 24 check-ins 8 free-text entries 0 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 990 / WA
Registered: 2021-04-06

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

2021-04-06
Registered in v-safe
2021-04-06
Dose 1 — Moderna
2021-04-06
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · None

Adult check-in
2021-04-09
Survey response — days 1–6 daily, dose 1
MedDRA: Gingivitis — Feeling: Fair · Site: Pain

Free text: Infection in gum line

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — days 1–6 daily, dose 1
MedDRA: Gingivitis — Feeling: Poor · Be unable to do your normal daily activities

Free text: Gum infection probably not related to vaccine.

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

Adult check-in
2021-04-12
Survey response — days 1–6 daily, dose 1
MedDRA: Noninfective gingivitis, Swelling face — Feeling: Fair · Be unable to do your normal daily activities

Free text: Facial swelling from gum inflammation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — day 7, dose 1
MedDRA: Facial pain, Swelling face — Feeling: Fair · Chills

Free text: Pain and swelling on side of face from possible sinus or gum infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-27
Survey response — day 21, dose 1
MedDRA: Headache, Malaise, Nausea — Feeling: Poor · Be unable to do your normal daily activities

Free text: Nausea, headache, malaise

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Dose 2 — Moderna
2021-05-11
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-05-12
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Condition aggravated, Injection site pain, Pain, Pre-existing disease — Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: All of my pains (other than mild tenderness at injection site) are related to pre-existing injuries, but I suspect a generalized inflammatory response has aggravated them. Ice packs for injuries may contribute to or cause the chills Im experiencing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
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
2021-05-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches

Adult check-in
2021-05-15
Survey response — days 1–6 daily, dose 2
MedDRA: Rash, Rash erythematous — Feeling: Good · Muscle or body aches, Rash, not including the immediate area around the injection site

Free text: Rash is more like a few very small bright red blood filled bumps scattered on arms and legs.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Rash, not including the immediate area around the injection site

Adult check-in
2021-05-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-05-18
Health check-in — day 7, dose 2
Feeling: Good · Fever · Rash, not including the immediate area around the injection site

Adult check-in
2021-05-25
Survey response — day 14, dose 2
MedDRA: Inflammation — Feeling: Poor · Be unable to do your normal daily activities

Free text: Knee inflammation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-10
Health check-in — 3 months, dose 2
Feeling: Good

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

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-06	Moderna
2	2021-05-11	Moderna

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-09

Systemic reaction (other): Infection in gum line

2021-04-10

Systemic reaction (other): Gum infection probably not related to vaccine.

2021-04-12

Systemic reaction (other): Facial swelling from gum inflammation

Release 7 — day 7, dose 1

2021-04-13

Systemic reaction (other): Pain and swelling on side of face from possible sinus or gum infection

Release 8 — day 21, dose 1

2021-04-27

Symptoms: Nausea, headache, malaise

Release 8 — days 1–6 daily, dose 2

2021-05-12

Systemic reaction (other): All of my pains (other than mild tenderness at injection site) are related to pre-existing injuries, but I suspect a generalized inflammatory response has aggravated them. Ice packs for injuries may contribute to or cause the chills Im experiencing.

2021-05-15

Systemic reaction (other): Rash is more like a few very small bright red blood filled bumps scattered on arms and legs.

Release 8 — day 14, dose 2

2021-05-25

Symptoms: Knee inflammation

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	Headache	✓	✓	✓
SD	Inflammation	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Nausea	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Facial pain	✓	✓	✓
SRO	Gingivitis	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Noninfective gingivitis	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash erythematous	✓	✓	✓
SRO	Swelling face	✓	✓	✓

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