2VQ-31536-00278

2 vaccinations 6 coded responses 11 check-ins 6 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 341 / FL
Registered: 2021-02-21

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

2021-02-18
Dose 1 — Moderna
2021-02-21
Registered in v-safe
2021-02-21
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Poor · Site: Pain, Redness, Swelling · Muscle or body aches · Be unable to do your normal daily activities

Free text: Extreme pain down left leg.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness, Swelling · Muscle or body aches · Be unable to work

Adult check-in
2021-02-23
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Site: Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, 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: MRI

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-24
Survey response — days 1–6 daily, dose 1
MedDRA: Pain, Pre-existing disease, Unevaluable event — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to work, 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: Systemic reaction (other): Degenerative discs pain episode since 24 hours after vaccine. · Healthcare visit (other): MRI

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 1
Be unable to work · 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 — day 7, dose 1
MedDRA: Pain in extremity — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to work, 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: Leg pain due to back

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Report sent to call center — day 7, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-18
Dose 2 — Moderna
2021-03-18
Health check-in — day 0, dose 2
Feeling: Fair · Headache

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: Oral herpes — Feeling: Fair · Site: Swelling · Headache, Muscle or body aches, Rash, not including the immediate area around the injection site

Free text: Cold sore appeared yesterday on mouth.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None · Be unable to do your normal daily activities

Adult check-in
2021-04-01
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-09-16
Survey response — 6 months, dose 2
MedDRA: Asthma, Fatigue, Hallucination, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Severe asthma for months, hallucinations, tiredness, 9 months of Prednisone and alternate antibiotics, many trips to g.p. , pulmonologist. Irregular cd of lungs. · Healthcare visit (other): Constant pulmonologist and internist appointments. Overabundance of lung medications since 12-9-2020.

MedDRA releases: 2024-11 · check-in free text available
2021-09-16
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-17
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-18	Moderna
2	2021-03-18	Moderna

Call center

4 call center cases

4 unsuccessful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-21

Systemic reaction (other): Extreme pain down left leg.

2021-02-23

Healthcare visit (other): MRI

2021-02-24

Systemic reaction (other): Degenerative discs pain episode since 24 hours after vaccine.

Healthcare visit (other): MRI

Release 4 — day 7, dose 1

2021-02-27

Systemic reaction (other): Leg pain due to back

Release 6 — days 1–6 daily, dose 2

2021-03-20

Systemic reaction (other): Cold sore appeared yesterday on mouth.

Release 9 — 6 months, dose 2

2021-09-16

Symptoms: Severe asthma for months, hallucinations, tiredness, 9 months of Prednisone and alternate antibiotics, many trips to g.p. , pulmonologist. Irregular cd of lungs.

Healthcare visit (other): Constant pulmonologist and internist appointments. Overabundance of lung medications since 12-9-2020.

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	Office visit	·	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Asthma	·	·	✓
SD	Fatigue	·	·	✓
SD	Hallucination	·	·	✓
SD	Office visit	·	·	✓
SRO	Oral herpes	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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