22G-30720-20469

2 vaccinations 7 coded responses 24 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 802 / CO
Registered: 2021-01-10

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

Timeline

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

2021-01-09
Dose 1 — Moderna
2021-01-10
Registered in v-safe
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fever · Headache

Adult check-in
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-16
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-23
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth — Feeling: Good

Free text: 8 days after shot my arm near injectiom point was sixe if tennis ball, beet read, itchy, and very hot. It grew 1 inch every 12 hours growing to 7Ã—5. Initialky used cold compresd. Didnt work. Moved to hydrocortisone and Loratidine 3 day later. Now do

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Survey response — day 21, dose 1
MedDRA: Pain in extremity — Feeling: Good

Free text: New round of soreness in arm INNOCULATED from elbow to shoulder 3 daysDAULY 16-18

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Dose 2 — Moderna
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Limb discomfort, Lymph node pain, Treatment noncompliance, Tremor — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Tremors, very heavy arm, lymph nodes sore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Gait disturbance, Tremor, Urticaria — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Tremots, welt/hive 4x4, unsteady on feet

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Survey response — days 1–6 daily, dose 2
MedDRA: Rash — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Rash now covers elbow to shoulders exceot underside of arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills, Headache, Muscle or body aches, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-02-13
Health check-in — day 7, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-02-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-27
Survey response — day 21, dose 2
MedDRA: Dyspnoea — Feeling: Good · Be unable to do your normal daily activities

Free text: More out of breath easier

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-13
Survey response — day 35, dose 2
MedDRA: Loss of personal independence in daily activities — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Had medical necessity Botox shots 2 weeks after my signifucant reaction to #2 Moderna. Shot was delayed due to reaction. Well i had significant reaction likewise to the shit, unusual. Had to stop my temporary work, now believed to be related.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Report sent to call center — day 35, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-21
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — 3 months, dose 2
Feeling: Good

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

Adult check-in
2022-02-06
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-03-02
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-09	Moderna
2	2021-02-06	Moderna

Call center

1 call center case

1 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 2 — day 14, dose 1

2021-01-23

Symptoms: 8 days after shot my arm near injectiom point was sixe if tennis ball, beet read, itchy, and very hot. It grew 1 inch every 12 hours growing to 7Ã—5. Initialky used cold compresd. Didnt work. Moved to hydrocortisone and Loratidine 3 day later. Now do cut off by CDC

Release 3 — day 21, dose 1

2021-02-01

Symptoms: New round of soreness in arm INNOCULATED from elbow to shoulder 3 daysDAULY 16-18

Release 3 — days 1–6 daily, dose 2

2021-02-07

Systemic reaction (other): Tremors, very heavy arm, lymph nodes sore

2021-02-08

Systemic reaction (other): Tremots, welt/hive 4x4, unsteady on feet

2021-02-09

Systemic reaction (other): Rash now covers elbow to shoulders exceot underside of arm

Release 4 — day 21, dose 2

2021-02-27

Symptoms: More out of breath easier

Release 5 — day 35, dose 2

2021-03-13

Symptoms: Had medical necessity Botox shots 2 weeks after my signifucant reaction to #2 Moderna. Shot was delayed due to reaction. Well i had significant reaction likewise to the shit, unusual. Had to stop my temporary work, now believed to be related.

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	Dyspnoea	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Loss of personal independence in daily activities	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SRO	Gait disturbance	✓	✓	✓
SRO	Limb discomfort	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Treatment noncompliance	○	✓	○
SRO	Tremor	✓	✓	✓
SRO	Urticaria	✓	✓	✓

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