ZZC-12509-03941

3 vaccinations 17 coded responses 24 check-ins 17 free-text entries 0 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 300 / GA
Registered: 2021-09-16

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

2021-09-14
Dose 1 — Moderna
2021-09-16
Registered in v-safe
2021-09-16
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-09-17
Survey response — days 1–6 daily, dose 1
MedDRA: Urinary incontinence — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: The day before i couldn't control my bladder after waking up once only

MedDRA releases: 2024-11 · check-in free text available
2021-09-18
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling of body temperature change — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I have been being hot and cold at same time for days after shot and still am having that problem

MedDRA releases: 2024-11 · check-in free text available
2021-09-19
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling of body temperature change — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: I have been ice cold and other half of my body hot very hot still

MedDRA releases: 2024-11 · check-in free text available
2021-09-21
Survey response — day 7, dose 1
MedDRA: Pre-existing disease, Systemic lupus erythematosus — Feeling: Poor · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: I have lupus and I'm in the worst flare I've ever had.

MedDRA releases: 2024-11 · check-in free text available
2021-09-28
Survey response — day 14, dose 1
MedDRA: Headache, Heart rate increased, Pain in jaw, Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activities

Free text: Worse kind of headache and jaw pain ever had and ever since the vaccine my heart has been beating really faster than it use to due to my health problems with lupus and other autoimmune diseases.

MedDRA releases: 2024-11 · check-in free text available
2021-10-05
Survey response — day 21, dose 1
MedDRA: Arthralgia, Neck pain, Pain in extremity — Feeling: Poor · Be unable to do your normal daily activities

Free text: The arm i got the shot in has been in the worst pain in my hands, wrists and shoulder, neck and all my joints. Actually all my joints are in worst pain.

MedDRA releases: 2024-11 · check-in free text available
2021-10-12
Dose 2 — Moderna
2021-10-12
Survey response — day 0, dose 2
MedDRA: Pre-existing disease, Systemic lupus erythematosus — Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Abdominal pain · Be unable to do your normal daily activities

Free text: I have Lupus and 1st vaccine put me in a bad flare, just got the 2nd shot today.

MedDRA releases: 2024-11 · check-in free text available
2021-10-13
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · 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
2021-10-14
Survey response — days 1–6 daily, dose 2
MedDRA: Joint injury, Limb injury, Weight bearing difficulty — Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: I have either broken my ankle or foot and don't know how i can get to doctor cause I can't put any weight on it.

MedDRA releases: 2024-11 · check-in free text available
2021-10-15
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site rash, Lip blister, Pre-existing disease, Systemic lupus erythematosus — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: I now have a big rash all over my upper arm where the shot was given, and now have a blister on my lip. I am now in a flare from my lupus, one worse than ever.

MedDRA releases: 2024-11 · check-in free text available
2021-10-16
Survey response — days 1–6 daily, dose 2
MedDRA: Ankle fracture, Pre-existing disease, Systemic lupus erythematosus — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: In bad lupus flare and have a broken ankle

MedDRA releases: 2024-11 · check-in free text available
2021-10-17
Survey response — days 1–6 daily, dose 2
MedDRA: Condition aggravated, Joint injury, Pre-existing disease — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Been thrown into the worst flare I've ever had, and still need to go somehow to get my knee x rayed to see how bad broken.

MedDRA releases: 2024-11 · check-in free text available
2021-10-18
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · 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
2021-10-19
Survey response — day 7, dose 2
MedDRA: Arthralgia, Pre-existing disease, Systemic lupus erythematosus — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Still in lupus flare and my joints are hurting pretty badly

MedDRA releases: 2024-11 · check-in free text available
2021-10-26
Health check-in — day 14, dose 2
Feeling: Poor

Adult check-in
2021-11-02
Survey response — day 21, dose 2
MedDRA: Angina pectoris, Chest pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: My heart still hurts and my chest has been hurting and don't know why til i can get to a doctor.

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Health check-in — day 28, dose 2
Feeling: Poor

Adult check-in
2021-11-23
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2022-01-11
Health check-in — 3 months, dose 2
Feeling: Poor

Adult check-in
2022-04-09
Dose 3 — Moderna
2022-04-11
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site erythema, Injection site swelling — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Its also swollen and red n hurts at the injection site.

MedDRA releases: 2024-11 · check-in free text available
2022-04-12
Survey response — days 1–6 daily, dose 3
MedDRA: Breast discomfort, Breast swelling, Erythema, Swelling — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: The redness keeps getting bigger n more swollen and there's a swollen under my breasts that feels wrong

MedDRA releases: 2024-11 · check-in free text available
2022-04-13
Survey response — days 1–6 daily, dose 3
MedDRA: Adverse reaction — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: This has to be a adverse reaction and never getting another one.

MedDRA releases: 2024-11 · check-in free text available
2022-04-14
Survey response — days 1–6 daily, dose 3
MedDRA: Adverse reaction — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Had a adverse reaction, never again

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-09-14	Moderna	No
2	2021-10-12	Moderna	No
3	2022-04-09	Moderna	No

Free text

Release 9 — days 1–6 daily, dose 1

2021-09-17

Systemic reaction (other): The day before i couldn't control my bladder after waking up once only

2021-09-18

Systemic reaction (other): I have been being hot and cold at same time for days after shot and still am having that problem

2021-09-19

Systemic reaction (other): I have been ice cold and other half of my body hot very hot still

Release 9 — day 7, dose 1

2021-09-21

Systemic reaction (other): I have lupus and I'm in the worst flare I've ever had.

Release 9 — day 14, dose 1

2021-09-28

Symptoms: Worse kind of headache and jaw pain ever had and ever since the vaccine my heart has been beating really faster than it use to due to my health problems with lupus and other autoimmune diseases.

Release 10 — day 21, dose 1

2021-10-05

Symptoms: The arm i got the shot in has been in the worst pain in my hands, wrists and shoulder, neck and all my joints. Actually all my joints are in worst pain.

Release 10 — day 0, dose 2

2021-10-12

Systemic reaction (other): I have Lupus and 1st vaccine put me in a bad flare, just got the 2nd shot today.

Release 10 — days 1–6 daily, dose 2

2021-10-14

Systemic reaction (other): I have either broken my ankle or foot and don't know how i can get to doctor cause I can't put any weight on it.

2021-10-15

Systemic reaction (other): I now have a big rash all over my upper arm where the shot was given, and now have a blister on my lip. I am now in a flare from my lupus, one worse than ever.

2021-10-16

Systemic reaction (other): In bad lupus flare and have a broken ankle

2021-10-17

Systemic reaction (other): Been thrown into the worst flare I've ever had, and still need to go somehow to get my knee x rayed to see how bad broken.

Release 10 — day 7, dose 2

2021-10-19

Systemic reaction (other): Still in lupus flare and my joints are hurting pretty badly

Release 10 — day 21, dose 2

2021-11-02

Symptoms: My heart still hurts and my chest has been hurting and don't know why til i can get to a doctor.

Release 11 — days 1–6 daily, dose 3

2022-04-11

Systemic reaction (other): Its also swollen and red n hurts at the injection site.

2022-04-12

Systemic reaction (other): The redness keeps getting bigger n more swollen and there's a swollen under my breasts that feels wrong

2022-04-13

Systemic reaction (other): This has to be a adverse reaction and never getting another one.

2022-04-14

Systemic reaction (other): Had a adverse reaction, never again

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	Angina pectoris	·	·	✓
SD	Arthralgia	·	·	✓
SD	Chest pain	·	·	✓
SD	Headache	·	·	✓
SD	Heart rate increased	·	·	✓
SD	Neck pain	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Pain in jaw	·	·	✓
SD	Pre-existing disease	·	·	✓
SRO	Adverse reaction	·	·	✓
SRO	Ankle fracture	·	·	✓
SRO	Arthralgia	·	·	✓
SRO	Breast discomfort	·	·	✓
SRO	Breast swelling	·	·	✓
SRO	Condition aggravated	·	·	✓
SRO	Erythema	·	·	✓
SRO	Feeling of body temperature change	·	·	✓
SRO	Injection site erythema	·	·	✓
SRO	Injection site rash	·	·	✓
SRO	Injection site swelling	·	·	✓
SRO	Joint injury	·	·	✓
SRO	Limb injury	·	·	✓
SRO	Lip blister	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Swelling	·	·	✓
SRO	Systemic lupus erythematosus	·	·	✓
SRO	Urinary incontinence	·	·	✓
SRO	Weight bearing difficulty	·	·	✓

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