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2AJ-99447-66431

1 vaccination 5 coded responses 11 check-ins 5 free-text entries 2 call cases
Sex
Female
Age at first dose
56-60
ZIP prefix
972 / OR
Registered
2021-02-09
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
BJ3-81630-28614 Other · Female · 2021-10-24

Timeline

  1. 2021-02-09
    Registered in v-safe
  2. 2021-02-09
    Dose 1 — Moderna
  3. 2021-02-09
    Survey response — day 0, dose 1
    MedDRA: Arthralgia, Chills, Myalgia, Pain in extremity — Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches
    Free text: felt good but 4hrs after injection, arm started hurting...10hrs later pain 5/10 & Chills, muscle&joint pain
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-02-10
    Survey response — days 1–6 daily, dose 1
    MedDRA: Unevaluable event — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Free text: this is actually my 2nd Moderna shot, wasnt able to correct it in the app
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-02-11
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness
    Adult check-in
  6. 2021-02-13
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-02-14
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  8. 2021-02-15
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-02-16
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-02-23
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-03-02
    Survey response — day 21, dose 1
    MedDRA: Back pain, Pre-existing disease — Feeling: Good
    Free text: Back ache but don't believe it is related...I get this upon occasion even before the vaccine. Usually strain of muscles or urinary tract infection. Not debilitating or new to me.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-08-10
    Survey response — 6 months, dose 1
    MedDRA: Headache, Rhinorrhoea, SARS-CoV-2 test negative, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Symptoms: Headache, runny nose for a couple days ladt month. Got a covid19 test thru Kaiser Permanente - not detected. · Healthcare visit (other): Approval for Covid19 test
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  13. 2021-08-10
    Report sent to call center — 6 months, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  14. 2021-12-01
  15. 2021-12-06
  16. 2022-02-09
    Survey response — 12 months, dose 1
    MedDRA: Urinary tract infection — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Uti
    MedDRA releases: 2024-11 · check-in free text available
  17. 2022-02-09
    Report sent to call center — 12 months, dose 1
    Be unable to work or attend school · Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  18. 2022-02-11
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

DoseDateManufacturerCo-administered
12021-02-09Moderna

Call center

2 call center cases

2 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 3 — day 0, dose 1

2021-02-09

Systemic reaction (other): felt good but 4hrs after injection, arm started hurting...10hrs later pain 5/10 & Chills, muscle&joint pain

Release 4 — days 1–6 daily, dose 1

2021-02-10

Systemic reaction (other): this is actually my 2nd Moderna shot, wasnt able to correct it in the app

Release 4 — day 21, dose 1

2021-03-02

Symptoms: Back ache but don't believe it is related...I get this upon occasion even before the vaccine. Usually strain of muscles or urinary tract infection. Not debilitating or new to me.

Release 9 — 6 months, dose 1

2021-08-10

Symptoms: Headache, runny nose for a couple days ladt month. Got a covid19 test thru Kaiser Permanente - not detected.
Healthcare visit (other): Approval for Covid19 test

Release 11 — 12 months, dose 1

2022-02-09

Symptoms: Uti

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
HCVOUnevaluable event ✓ · ✓
SDBack pain ✓ ✓ ✓
SDHeadache ✓ · ✓
SDPre-existing disease ✓ ✓ ✓
SDRhinorrhoea ✓ · ✓
SDSARS-CoV-2 test negative ✓ · ✓
SDUrinary tract infection · · ✓
SROArthralgia ✓ ✓ ✓
SROChills ✓ ✓ ✓
SROMyalgia ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROUnevaluable event ✓ ✓ ✓

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