2N6-82455-73129

2 vaccinations 8 coded responses 19 check-ins 8 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 857 / AZ
Registered: 2021-04-15

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

2021-04-15
Registered in v-safe
2021-04-15
Dose 1 — Moderna
2021-04-15
Survey response — day 0, dose 1
MedDRA: Unevaluable event — Feeling: Good

Free text: Before having the vaccine at 11 am-ish today I already had my usual minor joint pain in hip lower back & neck & I have a small red rash spot already on the underside of my right wrist all of which are unrelated to the vaccine so Im not marking anything on this question

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Neck pain, Renal pain, Self-medication — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Free text: Intermittent short sharp pain by right kidney reminds me of past kidne stone pain Ive had. Also strong neck & shoulder pain aches took Tylenol

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain, Renal pain — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Still have a small sharp intermittent lower back pain by right kidney reminiscent of kidney stone pain Im drinking lots of water

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal distension, Chest pain, Pain, Renal pain — Feeling: Good

Free text: Abdominal bloating wi low grade pain over weekend but better today & still have intermittent right kidney sharp pain but lessening

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal distension, Renal pain — Feeling: Good · Fatigue or tiredness

Free text: Minor aches minor kidney area pain much less , still have extra bloating

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal distension, Dyspnoea, Fatigue, Renal pain — Feeling: Fair · Muscle or body aches

Free text: Continuing low grade intermittent sharp pain by right kidney kidney area; bloating;fatigue; have forgotten to say when taking a walk have shortness of breath especially going up or down wages on my nature walk seems more since shot but maybe not connected

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — day 7, dose 1
MedDRA: Abdominal distension, Pain, Photopsia, Renal pain — Feeling: Good · Fatigue or tiredness

Free text: Less aches; still intermittent sharp pain by right kidney; some bloating; today both eyes this afternoon just started a bit of minor flashing or something as I look at my laptop for my work at home

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-13
Dose 2 — Moderna
2021-05-13
Health check-in — day 0, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-18
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain, Pre-existing disease, Respiratory tract congestion, Sinus congestion, Sneezing — Feeling: Fair · Fatigue or tiredness

Free text: A lot of sneezing, minor sore throat, a bit of sinus/ chest congestion- probably allergies

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
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-27
Health check-in — day 14, dose 2
Feeling: Good

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

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-15	Moderna
2	2021-05-13	Moderna

Free text

Release 7 — day 0, dose 1

2021-04-15

Systemic reaction (other): Before having the vaccine at 11 am-ish today I already had my usual minor joint pain in hip lower back & neck & I have a small red rash spot already on the underside of my right wrist all of which are unrelated to the vaccine so Im not marking anything on this question

Release 7 — days 1–6 daily, dose 1

2021-04-16

Systemic reaction (other): Intermittent short sharp pain by right kidney reminds me of past kidne stone pain Ive had. Also strong neck & shoulder pain aches took Tylenol

2021-04-17

Systemic reaction (other): Still have a small sharp intermittent lower back pain by right kidney reminiscent of kidney stone pain Im drinking lots of water

2021-04-19

Systemic reaction (other): Abdominal bloating wi low grade pain over weekend but better today & still have intermittent right kidney sharp pain but lessening

2021-04-20

Systemic reaction (other): Minor aches minor kidney area pain much less , still have extra bloating

2021-04-21

Systemic reaction (other): Continuing low grade intermittent sharp pain by right kidney kidney area; bloating;fatigue; have forgotten to say when taking a walk have shortness of breath especially going up or down wages on my nature walk seems more since shot but maybe not connected

Release 7 — day 7, dose 1

2021-04-22

Systemic reaction (other): Less aches; still intermittent sharp pain by right kidney; some bloating; today both eyes this afternoon just started a bit of minor flashing or something as I look at my laptop for my work at home

Release 8 — days 1–6 daily, dose 2

2021-05-18

Systemic reaction (other): A lot of sneezing, minor sore throat, a bit of sinus/ chest congestion- probably allergies

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
SRO	Abdominal distension	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Photopsia	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Renal pain	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Sinus congestion	✓	✓	✓
SRO	Sneezing	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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