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36J-13664-03617

2 vaccinations 7 coded responses 18 check-ins 7 free-text entries 1 call case
Sex
Female
Age at first dose
66+
ZIP prefix
122 / NY
Registered
2021-02-14
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-13
    Dose 1 — Moderna
  2. 2021-02-14
    Registered in v-safe
  3. 2021-02-14
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pain in extremity, Self-medication — Feeling: Good · Site: Pain
    Free text: I took two ibuprofen last night for the arm pain so that might be suppressing other symptoms.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-02-15
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  5. 2021-02-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  6. 2021-02-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-02-18
    Survey response — days 1–6 daily, dose 1
    MedDRA: Headache — Feeling: Good · Headache
    Free text: Intermittent headache around left eye socket.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-02-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Headache
    Adult check-in
  9. 2021-02-20
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-02-27
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-03-06
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-03-13
    Dose 2 — Moderna
  13. 2021-03-20
    Survey response — day 7, dose 2
    MedDRA: Induration, Peripheral swelling — Feeling: Good · Site: Swelling
    Free text: Four days after the shot my arm felt very firm and swollen. It has since improved.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-03-27
    Survey response — day 14, dose 2
    MedDRA: Abdominal pain upper, Loss of personal independence in daily activities — Feeling: Fair
    Free text: Stomach pain though I dont think it is related to the vaccine. I have to reduce my activities today.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-04-03
    Survey response — day 21, dose 2
    MedDRA: Neck pain, Pain — Feeling: Good
    Free text: Shooting pain in neck
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-04-10
    Survey response — day 28, dose 2
    MedDRA: Gastrointestinal disorder, Nasopharyngitis, Oropharyngeal pain, Pyrexia, Rhinorrhoea — Feeling: Good · Be unable to do your normal daily activities
    Free text: GI illness apparently related to food lasting one day followed by a mild cold with sore throat, runny nose and fever lasting three days. The GI condition was debilitating.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-04-17
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-04-24
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-06-12
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-09-11
    Survey response — 6 months, dose 2
    MedDRA: Arthralgia — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Right knee pain
    MedDRA releases: 2024-11 · check-in free text available
  21. 2021-09-11
    Report sent to call center — 6 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  22. 2021-09-20
  23. 2021-09-21
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  24. 2022-03-13
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-13Moderna
22021-03-13Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-14

Systemic reaction (other): I took two ibuprofen last night for the arm pain so that might be suppressing other symptoms.

2021-02-18

Systemic reaction (other): Intermittent headache around left eye socket.

Release 6 — day 7, dose 2

2021-03-20

Systemic reaction (other): Four days after the shot my arm felt very firm and swollen. It has since improved.

Release 6 — day 14, dose 2

2021-03-27

Symptoms: Stomach pain though I dont think it is related to the vaccine. I have to reduce my activities today.

Release 6 — day 21, dose 2

2021-04-03

Symptoms: Shooting pain in neck

Release 7 — day 28, dose 2

2021-04-10

Symptoms: GI illness apparently related to food lasting one day followed by a mild cold with sore throat, runny nose and fever lasting three days. The GI condition was debilitating.

Release 9 — 6 months, dose 2

2021-09-11

Symptoms: Right knee pain

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

FieldPreferred term2021-092023-042024-11
SDAbdominal pain upper ✓ ✓ ✓
SDArthralgia · · ✓
SDGastrointestinal disorder ✓ ✓ ✓
SDLoss of personal independence in daily activities ✓ ✓ ✓
SDNasopharyngitis ✓ ✓ ✓
SDNeck pain ✓ ✓ ✓
SDOropharyngeal pain ✓ ✓ ✓
SDPain ✓ ✓ ✓
SDPyrexia ✓ ✓ ✓
SDRhinorrhoea ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SROInduration ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROPeripheral swelling ✓ ✓ ✓
SROSelf-medication ✓ ✓ ✓

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