2JK-18636-39415

2 vaccinations 11 coded responses 25 check-ins 11 free-text entries 0 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 725 / AR
Registered: 2021-04-07

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

2021-04-07
Registered in v-safe
2021-04-07
Dose 1 — Moderna
2021-04-07
Survey response — day 0, dose 1
MedDRA: Ear pain, Pain — Feeling: Good · Site: Pain · Fever

Free text: Under chin ,leftside sore and left ear hurts (pain scale: 2)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-09
Survey response — days 1–6 daily, dose 1
MedDRA: Ear pain, Fatigue, Pain, Pyrexia, Somnolence — Feeling: Fair · Site: Pain · Fever · Headache

Free text: Ears both hurt,under my chin sore, tired,sleepy run down feeling ,slight feverish feeling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-12
Survey response — days 1–6 daily, dose 1
MedDRA: Irritability — Feeling: Fair · Fatigue or tiredness, Nausea

Free text: Woke up very irritable . I never wake up like that normally

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — days 1–6 daily, dose 1
MedDRA: Emotional distress — Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Emotional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — day 7, dose 1
MedDRA: Somnolence — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I'm extremely sleepy ,falling asleep Alot during the the day

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-28
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-13
Dose 2 — Moderna
2021-05-13
Survey response — day 0, dose 2
MedDRA: Back pain, Neck pain — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Neck sore and Lower back hurts

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — days 1–6 daily, dose 2
MedDRA: Neck pain, Pain — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Neck hurts to turn

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-05-17
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia — Feeling: Poor · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: extremely weak

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Backaches in center ....

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-20
Survey response — day 7, dose 2
MedDRA: Abdominal pain, Back pain — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Abdomen hurts,lower back hurts

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-06-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-10
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-06-17
Survey response — day 35, dose 2
MedDRA: Bone pain, Pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Pain or burning left of center of breast bone.It comes and goes . It's worse at times when moving . Sometimes feels sore . Doesn't affect my breathing . No pressure .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-14
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-11-11
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-05-13
Health check-in — 12 months, dose 2
Feeling: Poor

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-07	Moderna
2	2021-05-13	Moderna

Free text

Release 7 — day 0, dose 1

2021-04-07

Systemic reaction (other): Under chin ,leftside sore and left ear hurts (pain scale: 2)

Release 7 — days 1–6 daily, dose 1

2021-04-09

Systemic reaction (other): Ears both hurt,under my chin sore, tired,sleepy run down feeling ,slight feverish feeling

2021-04-12

Systemic reaction (other): Woke up very irritable . I never wake up like that normally

2021-04-13

Systemic reaction (other): Emotional

Release 7 — day 7, dose 1

2021-04-14

Systemic reaction (other): I'm extremely sleepy ,falling asleep Alot during the the day

Release 8 — day 0, dose 2

2021-05-13

Systemic reaction (other): Neck sore and Lower back hurts

Release 8 — days 1–6 daily, dose 2

2021-05-14

Systemic reaction (other): Neck hurts to turn

2021-05-17

Systemic reaction (other): extremely weak

2021-05-18

Systemic reaction (other): Backaches in center ....

Release 8 — day 7, dose 2

2021-05-20

Systemic reaction (other): Abdomen hurts,lower back hurts

Release 9 — day 35, dose 2

2021-06-17

Symptoms: Pain or burning left of center of breast bone.It comes and goes . It's worse at times when moving . Sometimes feels sore . Doesn't affect my breathing . No pressure .

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	Bone pain	✓	✓	✓
SD	Pain	✓	✓	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Emotional distress	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Irritability	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Somnolence	✓	✓	✓

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