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3EG-18781-01071

3 vaccinations 20 coded responses 34 check-ins 20 free-text entries 2 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
020 / MA
Registered
2021-03-01
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-24
    Dose 1 — Moderna
  2. 2021-03-01
    Registered in v-safe
  3. 2021-03-01
    Survey response — days 1–6 daily, dose 1
    MedDRA: Lymph node pain — Feeling: Good · Chills, Fatigue or tiredness
    Free text: Limp node pain
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-02
    Survey response — days 1–6 daily, dose 1
    MedDRA: Lymph node pain — Feeling: Good · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: limp node pain
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-05
    Survey response — day 7, dose 1
    MedDRA: Unevaluable event — Feeling: Fair · Headache, Joint pains, Muscle or body aches
    Free text: Lumo node
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-03-12
    Survey response — day 14, dose 1
    MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Hips are boothering me. Need replacement and does not have anything to do with vaccine.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-03-17
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  8. 2021-03-24
    Dose 2 — Moderna
  9. 2021-03-24
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain, Swelling · None
    Adult check-in
  10. 2021-03-25
    Survey response — days 1–6 daily, dose 2
    MedDRA: Abdominal distension, Constipation, Flatulence, Joint swelling — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities
    Free text: Bloaring, gasseous, constipation; extreme swelling of knees,
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-03-26
    Survey response — days 1–6 daily, dose 2
    MedDRA: Insomnia, Oral herpes — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: cold sores are healing; was able to sleep last night
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-03-27
    Survey response — days 1–6 daily, dose 2
    MedDRA: Fatigue, Injection site erythema, Injection site pruritus, Pain in extremity — Feeling: Fair · Site: Pain, Redness, Itching · Joint pains, Fatigue or tiredness
    Free text: fingers are better with the help of CBD cream; fatigue is mild; arm pain is still there with slight redness and medium itchness-longer than the first shot; have not had any lymph node pain so far with this shot. Did with first that lasted two weeks
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-03-28
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Swelling, Itching · Joint pains, Fatigue or tiredness
    Adult check-in
  14. 2021-03-29
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  15. 2021-03-31
    Survey response — day 7, dose 2
    MedDRA: Insomnia — Feeling: Fair · Site: Swelling, Itching · Headache, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities
    Free text: Not zble to sleep again
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-04-08
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-04-14
    Survey response — day 21, dose 2
    MedDRA: Musculoskeletal discomfort — Feeling: Poor · Be unable to do your normal daily activities
    Free text: My hips are not doing well but I know they need replacement.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-04-21
    Survey response — day 28, dose 2
    MedDRA: Ear pruritus, Injection site reaction, Pruritus — Feeling: Good
    Free text: Itchness is back. Especially ears and both arms. Still feel injection site. Including wwhere i got shingles sho 2 years ago. The shingles injection sight has gotten worse since vaccine. Injections were not on same arm.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  19. 2021-04-28
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-05-05
    Survey response — day 42, dose 2
    MedDRA: Breast pain, Pain — Feeling: Good
    Free text: Monday I had a shotting oain across my breast. Lasted 2 seconds. Today I have had breast pain periodically all day. This happened for the first shot and kastes for two weeks and started 2 days after my first shot.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-06-23
    Survey response — 3 months, dose 2
    MedDRA: Breast pain, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Both shots on the left side. 1st shot had left breast pain. 2nd shot after 6 weeks I had great pain in my right breast for a good part of several days,called gyn and set an appointment for exam. All was fine but still have minor episodes. · Healthcare visit (other): my gyn
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-06-23
    Report sent to call center — 3 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  23. 2021-06-29
  24. 2021-09-22
    Health check-in — 6 months, dose 2
    Feeling: Fair
    Adult check-in
  25. 2021-11-02
    Dose 3 — Moderna
  26. 2021-11-02
    Health check-in — day 0, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  27. 2021-11-03
    Survey response — days 1–6 daily, dose 3
    MedDRA: Pain — Feeling: Good · Site: Pain · Muscle or body aches
    Free text: If I was busy doing things I did not even notice the pain or aches
    MedDRA releases: 2024-11 · check-in free text available
  28. 2021-11-05
    Survey response — days 1–6 daily, dose 3
    MedDRA: Unevaluable event — Feeling: Good · Site: Pain · Muscle or body aches
    Free text: Had shot 3:30 PM Tuesday Thursday I walked at a good clip for 1 hr 20 Mins which because I need two hips replaced is something I have not done in more months than I can remember. Wondering if there is cortisone or inflammatory in shot.
    MedDRA releases: 2024-11 · check-in free text available
  29. 2021-11-06
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  30. 2021-11-07
    Survey response — days 1–6 daily, dose 3
    MedDRA: Pollakiuria, Thirst — Feeling: Good
    Free text: still drinking a lot more than I usually do, which is a very good amount. Urinating a lot more also.
    MedDRA releases: 2024-11 · check-in free text available
  31. 2021-11-08
    Survey response — days 1–6 daily, dose 3
    MedDRA: Blood glucose increased — Feeling: Good
    Free text: My sugar counts are still 15-30 points higher depending on time of day. I was 114-124 first thing in the am and now I am at 130-145
    MedDRA releases: 2024-11 · check-in free text available
  32. 2021-11-09
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  33. 2021-11-16
    Survey response — day 14, dose 3
    MedDRA: Adverse reaction — Feeling: Good
    Free text: Any positive effect of the booster on my hips is starting to wear off.
    MedDRA releases: 2024-11 · check-in free text available
  34. 2021-11-23
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  35. 2021-11-30
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  36. 2021-12-07
    Survey response — day 35, dose 3
    MedDRA: Therapeutic response unexpected — Feeling: Good
    Free text: I rec'd my Flu shot 1 month after my booster; it also made able to walk with speed & distance without any pain. I am assuming that in 2 weeks I will go back to my hips not letting me do this. Question what vaccines have to do with this-coincidence?
    MedDRA releases: 2024-11 · check-in free text available
  37. 2021-12-14
    Survey response — day 42, dose 3
    MedDRA: Arthralgia — Feeling: Fair
    Free text: Hips are bothering me. They need to be replaced and waiting for restrictions to end so the can be.
    MedDRA releases: 2024-11 · check-in free text available
  38. 2022-02-01
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  39. 2022-05-03
    Survey response — 6 months, dose 3
    MedDRA: Office visit, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Steroid shots to both hips. Waiting time for fourth shot. · Healthcare visit (other): Dr. Office
    MedDRA releases: 2024-11 · check-in free text available
  40. 2022-05-03
    Report sent to call center — 6 months, dose 3
    Get care from a doctor or other healthcare professional
    1 call case(s)
  41. 2022-05-04
  42. 2022-05-09
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  43. 2022-05-09
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  44. 2022-11-02
    Health check-in — 12 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-24Moderna
22021-03-24Moderna
32021-11-02Moderna No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-03-01

Systemic reaction (other): Limp node pain

2021-03-02

Systemic reaction (other): limp node pain

Release 5 — day 7, dose 1

2021-03-05

Systemic reaction (other): Lumo node

Release 5 — day 14, dose 1

2021-03-12

Symptoms: Hips are boothering me. Need replacement and does not have anything to do with vaccine.

Release 6 — days 1–6 daily, dose 2

2021-03-25

Systemic reaction (other): Bloaring, gasseous, constipation; extreme swelling of knees,

2021-03-26

Systemic reaction (other): cold sores are healing; was able to sleep last night

2021-03-27

Systemic reaction (other): fingers are better with the help of CBD cream; fatigue is mild; arm pain is still there with slight redness and medium itchness-longer than the first shot; have not had any lymph node pain so far with this shot. Did with first that lasted two weeks

Release 6 — day 7, dose 2

2021-03-31

Systemic reaction (other): Not zble to sleep again

Release 7 — day 21, dose 2

2021-04-14

Symptoms: My hips are not doing well but I know they need replacement.

Release 7 — day 28, dose 2

2021-04-21

Symptoms: Itchness is back. Especially ears and both arms. Still feel injection site. Including wwhere i got shingles sho 2 years ago. The shingles injection sight has gotten worse since vaccine. Injections were not on same arm.

Release 8 — day 42, dose 2

2021-05-05

Symptoms: Monday I had a shotting oain across my breast. Lasted 2 seconds. Today I have had breast pain periodically all day. This happened for the first shot and kastes for two weeks and started 2 days after my first shot.

Release 9 — 3 months, dose 2

2021-06-23

Symptoms: Both shots on the left side. 1st shot had left breast pain. 2nd shot after 6 weeks I had great pain in my right breast for a good part of several days,called gyn and set an appointment for exam. All was fine but still have minor episodes.
Healthcare visit (other): my gyn

Release 10 — days 1–6 daily, dose 3

2021-11-03

Systemic reaction (other): If I was busy doing things I did not even notice the pain or aches

2021-11-05

Systemic reaction (other): Had shot 3:30 PM Tuesday Thursday I walked at a good clip for 1 hr 20 Mins which because I need two hips replaced is something I have not done in more months than I can remember. Wondering if there is cortisone or inflammatory in shot.

2021-11-07

Systemic reaction (other): still drinking a lot more than I usually do, which is a very good amount. Urinating a lot more also.

2021-11-08

Systemic reaction (other): My sugar counts are still 15-30 points higher depending on time of day. I was 114-124 first thing in the am and now I am at 130-145

Release 10 — day 14, dose 3

2021-11-16

Symptoms: Any positive effect of the booster on my hips is starting to wear off.

Release 10 — day 35, dose 3

2021-12-07

Symptoms: I rec'd my Flu shot 1 month after my booster; it also made able to walk with speed & distance without any pain. I am assuming that in 2 weeks I will go back to my hips not letting me do this. Question what vaccines have to do with this-coincidence? cut off by CDC

Release 10 — day 42, dose 3

2021-12-14

Symptoms: Hips are bothering me. They need to be replaced and waiting for restrictions to end so the can be.

Release 11 — 6 months, dose 3

2022-05-03

Symptoms: Steroid shots to both hips. Waiting time for fourth shot.
Healthcare visit (other): Dr. Office

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
HCVOOffice visit ✓ ✓ ✓
SDAdverse reaction · · ✓
SDArthralgia ✓ ✓ ✓
SDBreast pain ✓ ✓ ✓
SDEar pruritus ✓ ✓ ✓
SDInjection site reaction ✓ ✓ ✓
SDMusculoskeletal discomfort ✓ ✓ ✓
SDPain ✓ ✓ ✓
SDPruritus ✓ ✓ ✓
SDTherapeutic response unexpected · · ✓
SDUnevaluable event · · ✓
SROAbdominal distension ✓ ✓ ✓
SROBlood glucose increased · · ✓
SROConstipation ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROFlatulence ✓ ✓ ✓
SROInjection site erythema ✓ ✓ ✓
SROInjection site pruritus ✓ ✓ ✓
SROInsomnia ✓ ✓ ✓
SROJoint swelling ✓ ✓ ✓
SROLymph node pain ✓ ✓ ✓
SROOral herpes ✓ ✓ ✓
SROPain · · ✓
SROPain in extremity ✓ ✓ ✓
SROPollakiuria · · ✓
SROThirst · · ✓
SROUnevaluable event ✓ ✓ ✓

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

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