ZN4-19639-44115

3 vaccinations 8 coded responses 36 check-ins 8 free-text entries 0 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 062 / CT
Registered: 2021-01-21

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

2021-01-21
Registered in v-safe
2021-01-21
Dose 1 — Moderna
2021-01-21
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches

Adult check-in
2021-01-24
Survey response — days 1–6 daily, dose 1
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to do your normal daily activities

Free text: I have behcets and I am have significant mouth sores more serious than usual

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Survey response — days 1–6 daily, dose 1
MedDRA: Skin lesion — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: I appear to have a reoccurance of my symptoms of behcets. However my skin lesions appear better today than yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — day 7, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-02-04
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-11
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-16
Dose 2 — Moderna
2021-02-16
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-17
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Pain in extremity, Peripheral swelling — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Swelling and throbbing of my left arm and hand

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Nausea

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-23
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-02
Survey response — day 14, dose 2
MedDRA: Lymphadenopathy, Stomatitis — Feeling: Good · Be unable to do your normal daily activities

Free text: Increase of mouth sores from my behest and swollen lymph nodes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-16
Survey response — day 28, dose 2
MedDRA: Gastrointestinal tract irritation — Feeling: Fair · Be unable to do your normal daily activities

Free text: Gi symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — day 35, dose 2
MedDRA: Lymphadenopathy, Stomatitis — Feeling: Fair

Free text: Mouth sores swollen glands and

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Survey response — day 42, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Autoimmune condition is worse

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-17
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Dose 3 — Moderna
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Muscle or body aches

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-29
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-05
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-21
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-21
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-22
Survey response — 6 months, dose 3
MedDRA: Tibia fracture — Feeling: Good · Be unable to work or attend school

Free text: Recent significant tibia fracture with possible osteoporosis

MedDRA releases: 2024-11 · check-in free text available
2022-10-22
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-21	Moderna
2	2021-02-16	Moderna
3	2021-10-22	Moderna	No

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-24

Systemic reaction (other): I have behcets and I am have significant mouth sores more serious than usual

2021-01-25

Systemic reaction (other): I appear to have a reoccurance of my symptoms of behcets. However my skin lesions appear better today than yesterday

Release 4 — days 1–6 daily, dose 2

2021-02-17

Systemic reaction (other): Swelling and throbbing of my left arm and hand

Release 4 — day 14, dose 2

2021-03-02

Symptoms: Increase of mouth sores from my behest and swollen lymph nodes

Release 5 — day 28, dose 2

2021-03-16

Symptoms: Gi symptoms

Release 6 — day 35, dose 2

2021-03-23

Symptoms: Mouth sores swollen glands and

Release 6 — day 42, dose 2

2021-03-30

Symptoms: Autoimmune condition is worse

Release 11 — 6 months, dose 3

2022-04-22

Symptoms: Recent significant tibia fracture with possible osteoporosis

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	Condition aggravated	✓	✓	✓
SD	Gastrointestinal tract irritation	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Stomatitis	✓	✓	✓
SD	Tibia fracture	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Skin lesion	✓	✓	✓

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