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29H-22129-67767

2 vaccinations 9 coded responses 9 check-ins 9 free-text entries 0 call cases
Sex
Female
Age at first dose
61-65
ZIP prefix
920 / CA
Registered
2021-04-25
Relationship
Self
Race
Native Hawaiian or other Pacific Islander
Ethnicity
N/A

Timeline

  1. 2021-03-21
    Dose 1 — Moderna
  2. 2021-04-18
    Dose 2 — Moderna
  3. 2021-04-25
    Registered in v-safe
  4. 2021-04-25
    Survey response — day 7, dose 2
    MedDRA: Dizziness — Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work
    Free text: Lightheadedness
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-05-03
    Survey response — day 14, dose 2
    MedDRA: Arthralgia, Ear pain, Headache, Nausea, Rash — Feeling: Fair
    Free text: Rash, waves of nausea, headaches around right temple/ear, joint ache
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-05-10
    Survey response — day 21, dose 2
    MedDRA: Arthralgia, Fatigue, Headache, Mobility decreased — Feeling: Fair
    Free text: Still having headaches & fatigue, joint pain and trouble with full range of motion on vaccinated arm
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-05-17
    Survey response — day 28, dose 2
    MedDRA: Headache, Myalgia, Tenderness — Feeling: Fair
    Free text: Arm still tender around muscle to shoulder with limiting range of motion. periodic headache around right temple
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-05-25
    Survey response — day 35, dose 2
    MedDRA: Discomfort, Pain, Sciatica, Sleep disorder — Feeling: Fair
    Free text: Still discomfort and pain when moving arm (ie reaching for seatbelt, raising arm on sofa back, sleeping with arm up) periodic feeling like sciatica on right hip
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-06-01
    Survey response — day 42, dose 2
    MedDRA: Ear pain, Headache, Joint range of motion decreased, Pain in extremity — Feeling: Fair
    Free text: Arm sore still experiencing ROM limitation. Periodic Headaches affecting right ear ache
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-07-18
    Survey response — 3 months, dose 2
    MedDRA: Back pain, Pain, Pain in extremity, Paraesthesia, Sciatica — Feeling: Fair
    Free text: Arm still hurts when reaching/extending (ie putting in seat belt, reaching overhead) back pain persists with feeling of shooting pain, tingling mainly right side similar to what I've read on siatica. When getting up from sitting or laying down.
    MedDRA releases: 2024-11 · check-in free text available
  11. 2021-10-19
    Survey response — 6 months, dose 2
    MedDRA: Back pain, Hypoaesthesia, Sciatica — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Backache lessened over time though sciatica like numbness is still an issue
    MedDRA releases: 2024-11 · check-in free text available
  12. 2022-04-20
    Survey response — 12 months, dose 2
    MedDRA: Injection site pain, Musculoskeletal stiffness — Feeling: Fair · Be unable to work or attend school
    Free text: Continued stiffness and sore where 3 vax shots given.
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-03-21Moderna
22021-04-18Moderna

Free text

Release 7 — day 7, dose 2

2021-04-25

Systemic reaction (other): Lightheadedness

Release 8 — day 14, dose 2

2021-05-03

Symptoms: Rash, waves of nausea, headaches around right temple/ear, joint ache

Release 8 — day 21, dose 2

2021-05-10

Symptoms: Still having headaches & fatigue, joint pain and trouble with full range of motion on vaccinated arm

Release 8 — day 28, dose 2

2021-05-17

Symptoms: Arm still tender around muscle to shoulder with limiting range of motion. periodic headache around right temple

Release 8 — day 35, dose 2

2021-05-25

Symptoms: Still discomfort and pain when moving arm (ie reaching for seatbelt, raising arm on sofa back, sleeping with arm up) periodic feeling like sciatica on right hip

Release 8 — day 42, dose 2

2021-06-01

Symptoms: Arm sore still experiencing ROM limitation. Periodic Headaches affecting right ear ache

Release 9 — 3 months, dose 2

2021-07-18

Symptoms: Arm still hurts when reaching/extending (ie putting in seat belt, reaching overhead) back pain persists with feeling of shooting pain, tingling mainly right side similar to what I've read on siatica. When getting up from sitting or laying down.

Release 10 — 6 months, dose 2

2021-10-19

Symptoms: Backache lessened over time though sciatica like numbness is still an issue

Release 11 — 12 months, dose 2

2022-04-20

Symptoms: Continued stiffness and sore where 3 vax shots given.

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

FieldPreferred term2021-092023-042024-11
SDArthralgia ✓ ✓ ✓
SDBack pain · · ✓
SDDiscomfort ✓ ✓ ✓
SDEar pain ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDHypoaesthesia · · ✓
SDInjection site pain · · ✓
SDJoint range of motion decreased ✓ ✓ ✓
SDMobility decreased ✓ ✓ ✓
SDMusculoskeletal stiffness · · ✓
SDMyalgia ✓ ✓ ✓
SDNausea ✓ ✓ ✓
SDPain ✓ ✓ ✓
SDPain in extremity ✓ ✓ ✓
SDParaesthesia · · ✓
SDRash ✓ ✓ ✓
SDSciatica ✓ ✓ ✓
SDSleep disorder ✓ ✓ ✓
SDTenderness ✓ ✓ ✓
SRODizziness ✓ ✓ ✓

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

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