2UW-18941-26470

2 vaccinations 9 coded responses 24 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 905 / CA
Registered: 2021-01-26

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

2021-01-26
Registered in v-safe
2021-01-26
Dose 1 — Moderna
2021-01-26
Survey response — day 0, dose 1
MedDRA: Pre-existing disease — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: I have Rheumatoid Arthritis so joint pain comes with it. So can not determine if it is caused by the vaccine. Also have Other types of Arthritis.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease, Rheumatoid arthritis — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Joints in fingers swollen more than normal. I have Rheumatoid Arthritis.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Survey response — days 1–6 daily, dose 1
MedDRA: Peripheral swelling, Pre-existing disease, Rheumatoid arthritis — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Rheumatoid Arthritis seems to have gotten worse. Fingers more swollen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Muscle or body aches

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-02-02
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-02-09
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-16
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-23
Dose 2 — Moderna
2021-02-23
Survey response — day 0, dose 2
MedDRA: No adverse event — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: No I just got the shot 15 minutes ago

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Dysstasia, Gait disturbance, Medical counselling, Pain — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Difficulty standing and walking, pain all over my body, called my doctor pain was so intense and chills so bad · Healthcare visit (other): Phone visit.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-26
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction, Fall, Lower limb fracture — Feeling: Fair · Chills, Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Yesterday I fell and broke 2 bones in my left leg. The day before I had almost all ofthree possible reaciomscclll

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Fall, Lower limb fracture — Feeling: Fair · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Two days after my vaccines be I fell and broke two bones in my left leg, so its difficult determining causes of pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Not any youll pay attention to!!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-09
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-18
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-23
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-30
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-08
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-25
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-08-24
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-12-29
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-02-23
Survey response — 12 months, dose 2
MedDRA: Abdominal discomfort, Chills, Hospitalisation, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Am in hospital with high fever, chills upset stomach.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-26	Moderna
2	2021-02-23	Moderna

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-26

Systemic reaction (other): I have Rheumatoid Arthritis so joint pain comes with it. So can not determine if it is caused by the vaccine. Also have Other types of Arthritis.

Release 2 — days 1–6 daily, dose 1

2021-01-27

Systemic reaction (other): Joints in fingers swollen more than normal. I have Rheumatoid Arthritis.

Release 3 — days 1–6 daily, dose 1

2021-01-28

Systemic reaction (other): Rheumatoid Arthritis seems to have gotten worse. Fingers more swollen

Release 4 — day 0, dose 2

2021-02-23

Systemic reaction (other): No I just got the shot 15 minutes ago

Release 4 — days 1–6 daily, dose 2

2021-02-24

Systemic reaction (other): Difficulty standing and walking, pain all over my body, called my doctor pain was so intense and chills so bad

Healthcare visit (other): Phone visit.

2021-02-26

Systemic reaction (other): Yesterday I fell and broke 2 bones in my left leg. The day before I had almost all ofthree possible reaciomscclll

2021-02-27

Systemic reaction (other): Two days after my vaccines be I fell and broke two bones in my left leg, so its difficult determining causes of pain.

2021-03-01

Systemic reaction (other): Not any youll pay attention to!!

Release 11 — 12 months, dose 2

2022-02-23

Symptoms: Am in hospital with high fever, chills upset stomach.

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
HCVO	Medical counselling	✓	✓	✓
SD	Abdominal discomfort	·	·	✓
SD	Chills	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Pyrexia	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Dysstasia	✓	✓	✓
SRO	Fall	✓	✓	✓
SRO	Gait disturbance	✓	✓	✓
SRO	Lower limb fracture	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Rheumatoid arthritis	✓	✓	✓

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