2W8-10499-84632

2 vaccinations 8 coded responses 9 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 067 / CT
Registered: 2021-03-15

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

2021-02-11
Dose 1 — Moderna
2021-03-12
Dose 2 — Moderna
2021-03-15
Registered in v-safe
2021-03-19
Survey response — day 7, dose 2
MedDRA: Axillary pain — Feeling: Good · Muscle or body aches

Free text: I HAVE PAIN IN LEFT ARMPIT WHERE LYMPH NODES WERE REMOVED FOR BREAST CANCER

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Survey response — day 14, dose 2
MedDRA: Fatigue, Pain, Pre-existing disease, Pyrexia — Feeling: Fair

Free text: EVER SINCE THE 2ND MODERNA VACCINE INJECTION I FEEL MORE TIRED.AFTER THE 2ND SHOT I HAD SEVERE PAIN THROUGHOUT MY BODY AND 100.5 FEVER.DOES THIS HAVE ANYTHING DO WITH MY O+ BLOOD TYPE OR THAT I HAD BREAST CANCER 2 YEARS AGO.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — day 21, dose 2
MedDRA: Breast pain, Fatigue — Feeling: Fair

Free text: I STILL FEEL TIRED DURING THE DAY AND HAVE PAIN IN MY BREAST WHERE I HAD CANCER.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — day 28, dose 2
MedDRA: Breast pain, Fatigue, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: MY BREAST STILL HURTS WHERE I HAD 2 LUMPECTOMIES. THE PAIN WAS SO BAD ON THURSDAY I SLEPT MOST OF THE DAY AND TOOK A DILAUDID. STILL FATIGUED.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — day 35, dose 2
MedDRA: Breast pain, Office visit, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I HAD AN APPOINTMENT WITH MY ONCOLOGIST, DR. BARGELLINI TO DISCUSS MY PAIN IN LEFT BREAST AFTER 2 LUMPECTOMIES.WE TALKED ABOUT MY 2ND INJECTION OF MODERNA 3/12/21 AND THE TERRIBLE EXCRUCIATING PAIN I HAD IN MY breast. A PROLIA INJECTION ON 3/29. · Healthcare visit (other): ONCOLOGIST

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-23
Survey response — day 42, dose 2
MedDRA: Breast pain, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: SAW PULMONOLOGIST AND I AM HAVING A CT SCAN AND CHEST XRAY AND DUPLEX VENOUS FOR LOWER EXTREMITY FOR PAIN IN MY LEFT BREAST WHICH IS CONSTANT WHEN I BREATH. Also bloodwork. · Healthcare visit (other): Pulminologist in person

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-13
Survey response — 3 months, dose 2
MedDRA: Headache, Office visit, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I HAVE HAD A HEADACHE FOR 2 WEEKS. HAD XRAYS. MAYBE FROM ARTHRITIS AND NECK FUSION. WILL TRY PHYSICAL THERAPY. · Healthcare visit (other): Orthopedic doctor in person.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-13
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-22
Call 1 — Left Voicemail
2021-09-10
Survey response — 6 months, dose 2
MedDRA: Lyme disease, Pyrexia — Feeling: Good · Be unable to do your normal daily activities

Free text: Lyme disease. Had 3 Moderna vaccine shot. Had 100.5 fever for 1 day.

MedDRA releases: 2024-11 · check-in free text available
2022-03-12
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-11	Moderna
2	2021-03-12	Moderna

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 5 — day 7, dose 2

2021-03-19

Systemic reaction (other): I HAVE PAIN IN LEFT ARMPIT WHERE LYMPH NODES WERE REMOVED FOR BREAST CANCER

Release 6 — day 14, dose 2

2021-03-28

Symptoms: EVER SINCE THE 2ND MODERNA VACCINE INJECTION I FEEL MORE TIRED.AFTER THE 2ND SHOT I HAD SEVERE PAIN THROUGHOUT MY BODY AND 100.5 FEVER.DOES THIS HAVE ANYTHING DO WITH MY O+ BLOOD TYPE OR THAT I HAD BREAST CANCER 2 YEARS AGO.

Release 6 — day 21, dose 2

2021-04-02

Symptoms: I STILL FEEL TIRED DURING THE DAY AND HAVE PAIN IN MY BREAST WHERE I HAD CANCER.

Release 7 — day 28, dose 2

2021-04-09

Symptoms: MY BREAST STILL HURTS WHERE I HAD 2 LUMPECTOMIES. THE PAIN WAS SO BAD ON THURSDAY I SLEPT MOST OF THE DAY AND TOOK A DILAUDID. STILL FATIGUED.

Release 7 — day 35, dose 2

2021-04-16

Symptoms: I HAD AN APPOINTMENT WITH MY ONCOLOGIST, DR. BARGELLINI TO DISCUSS MY PAIN IN LEFT BREAST AFTER 2 LUMPECTOMIES.WE TALKED ABOUT MY 2ND INJECTION OF MODERNA 3/12/21 AND THE TERRIBLE EXCRUCIATING PAIN I HAD IN MY breast. A PROLIA INJECTION ON 3/29.

Healthcare visit (other): ONCOLOGIST

Release 7 — day 42, dose 2

2021-04-23

Symptoms: SAW PULMONOLOGIST AND I AM HAVING A CT SCAN AND CHEST XRAY AND DUPLEX VENOUS FOR LOWER EXTREMITY FOR PAIN IN MY LEFT BREAST WHICH IS CONSTANT WHEN I BREATH. Also bloodwork.

Healthcare visit (other): Pulminologist in person

Release 9 — 3 months, dose 2

2021-06-13

Symptoms: I HAVE HAD A HEADACHE FOR 2 WEEKS. HAD XRAYS. MAYBE FROM ARTHRITIS AND NECK FUSION. WILL TRY PHYSICAL THERAPY.

Healthcare visit (other): Orthopedic doctor in person.

Release 9 — 6 months, dose 2

2021-09-10

Symptoms: Lyme disease. Had 3 Moderna vaccine shot. Had 100.5 fever for 1 day.

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	✓	✓	✓
SD	Breast pain	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Lyme disease	·	·	✓
SD	Office visit	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SRO	Axillary pain	✓	✓	✓

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