33T-22296-13004

4 vaccinations 9 coded responses 34 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 897 / NV
Registered: 2021-02-15

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

2021-02-12
Dose 1 — Moderna
2021-02-15
Registered in v-safe
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-16
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Headache

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-12
Dose 2 — Moderna
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Itching · Headache · Be unable to do your normal daily activities

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · Headache

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · Headache

Adult check-in
2021-03-19
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-11
Survey response — 3 months, dose 2
MedDRA: Surgery — Feeling: Good

Free text: Had shoulder replacement surgery on5/25/21. Feeling okay, no symptoms of Covid 19.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-14
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-08
Dose 3 — Moderna
2022-03-13
Survey response — 12 months, dose 2
MedDRA: Arthralgia, Back pain, Condition aggravated, Pre-existing disease — Feeling: Good · 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: Right shoulder pain plus right hip and lower back. The shoulder was replaced about 5 years ago. Having a CT scan done next week. Have had a fusion on lower back but ex-rays show a pulling away.

MedDRA releases: 2024-11 · check-in free text available
2022-03-13
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-15
Call 1 — Left Voicemail
2022-05-19
Dose 4 — Moderna
2022-05-19
Health check-in — day 0, dose 4
Feeling: Fair · None

Adult check-in
2022-05-20
Survey response — days 1–6 daily, dose 4
MedDRA: Chest pain, Cough, Oropharyngeal pain — Feeling: Poor · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: have had a sore throat for about 4 days. Now when I cough it hurts on right side of chest.

MedDRA releases: 2024-11 · check-in free text available
2022-05-22
Survey response — days 1–6 daily, dose 4
MedDRA: Nasopharyngitis — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: as far as I know I have a common cold

MedDRA releases: 2024-11 · check-in free text available
2022-05-23
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-05-25
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache

Adult check-in
2022-05-26
Survey response — day 7, dose 4
MedDRA: Unevaluable event — Feeling: Good

Free text: doing well today

MedDRA releases: 2024-11 · check-in free text available
2022-06-04
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-16
Survey response — day 28, dose 4
MedDRA: Arthralgia, Back pain, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Right shoulder and arm very painful and Right hip an lower back. These are not even but ee much worse lately.

MedDRA releases: 2024-11 · check-in free text available
2022-06-23
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-30
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-18
Survey response — 3 months, dose 4
MedDRA: COVID-19 — Feeling: Good · Be unable to do your normal daily activities

Free text: Contacted positive for Covid.

MedDRA releases: 2024-11 · check-in free text available
2022-11-18
Survey response — 6 months, dose 4
MedDRA: Bronchitis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Had bronchitis.

MedDRA releases: 2024-11 · check-in free text available
2022-11-18
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-11-21
Call 2 — Left Voicemail
2022-11-21
Call 1 — Left Voicemail
2023-05-19
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-12	Moderna
2	2021-03-12	Moderna
3	2021-12-08	Moderna	No
4	2022-05-19	Moderna	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-16

Systemic reaction (other): No

Release 9 — 3 months, dose 2

2021-06-11

Symptoms: Had shoulder replacement surgery on5/25/21. Feeling okay, no symptoms of Covid 19.

Release 11 — 12 months, dose 2

2022-03-13

Symptoms: Right shoulder pain plus right hip and lower back. The shoulder was replaced about 5 years ago. Having a CT scan done next week. Have had a fusion on lower back but ex-rays show a pulling away.

Release 11 — days 1–6 daily, dose 4

2022-05-20

Systemic reaction (other): have had a sore throat for about 4 days. Now when I cough it hurts on right side of chest.

2022-05-22

Systemic reaction (other): as far as I know I have a common cold

Release 11 — day 7, dose 4

2022-05-26

Systemic reaction (other): doing well today

Release 12 — day 28, dose 4

2022-06-16

Symptoms: Right shoulder and arm very painful and Right hip an lower back. These are not even but ee much worse lately.

Release 12 — 3 months, dose 4

2022-08-18

Symptoms: Contacted positive for Covid.

Release 12 — 6 months, dose 4

2022-11-18

Symptoms: Had bronchitis.

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	Arthralgia	·	·	✓
SD	Back pain	·	·	✓
SD	Bronchitis	·	·	✓
SD	Condition aggravated	·	·	✓
SD	COVID-19	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Surgery	✓	✓	✓
SRO	Chest pain	·	·	✓
SRO	Cough	·	·	✓
SRO	Nasopharyngitis	·	·	✓
SRO	No adverse event	✓	✓	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Unevaluable event	·	·	✓

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