3FU-10548-66922

4 vaccinations 8 coded responses 24 check-ins 8 free-text entries 0 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 952 / CA
Registered: 2021-11-06

Relationship: Self
Race: Asian
Ethnicity: Not Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-26
Dose 1 — Moderna
2021-04-23
Dose 2 — Moderna
2021-11-05
Dose 3 — Moderna
2021-11-06
Registered in v-safe
2021-11-06
Survey response — days 1–6 daily, dose 3
MedDRA: Muscular weakness — Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Muscle weakness

MedDRA releases: 2024-11 · check-in free text available
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Diarrhea

Adult check-in
2021-11-10
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-11
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches

Adult check-in
2021-11-12
Health check-in — day 7, dose 3
Feeling: Good · Headache, Muscle or body aches

Adult check-in
2021-11-19
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-12-03
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-12
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-04
Survey response — 3 months, dose 3
MedDRA: Sinus congestion, Tinnitus — Feeling: Fair

Free text: Sinus congestion started late Dec 2021 followed by tinnitus in left ear. Have used ear plug to minimize ringing. Ringing minimal upon waking however increases by late afternoon to evening.

MedDRA releases: 2024-11 · check-in free text available
2022-05-08
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-08
Dose 4 — Moderna
2022-10-10
Survey response — days 1–6 daily, dose 4
MedDRA: Arthralgia, Neck pain — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Severe Neck & upper shoulder pain

MedDRA releases: 2024-11 · check-in free text available
2022-10-11
Survey response — days 1–6 daily, dose 4
MedDRA: Arthralgia, Mobility decreased, Neck pain — Feeling: Fair · Site: Pain, Redness · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Neck & shoulder pain moderate difficulty turning head side to side

MedDRA releases: 2024-11 · check-in free text available
2022-10-12
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Redness, Swelling · Joint pains, Muscle or body aches, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-10-13
Survey response — days 1–6 daily, dose 4
MedDRA: Gait disturbance, Neuralgia — Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to do your normal daily activities

Free text: Nerve pains in both legs predominantly in upper thighs making simple walking difficult

MedDRA releases: 2024-11 · check-in free text available
2022-10-14
Survey response — days 1–6 daily, dose 4
MedDRA: Gait inability, Myositis, Neuralgia, Self-medication — Feeling: Fair · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Continued Muscle inflammation leading to nerve pain in both thighs impacting ability to walk. Took one 200mg Advil in morning, now 6 hrs later walking comfortably.

MedDRA releases: 2024-11 · check-in free text available
2022-10-15
Health check-in — day 7, dose 4
Feeling: Poor · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-23
Survey response — day 14, dose 4
MedDRA: Headache, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Nausea sporadic, intermittent headaches over the past 7 days.

MedDRA releases: 2024-11 · check-in free text available
2022-10-29
Survey response — day 21, dose 4
MedDRA: Gait disturbance, Myalgia, Neuralgia, Self-medication — Feeling: Fair · Be unable to do your normal daily activities

Free text: Nerve muscle pain makes walking difficult, using heated therma pak, salon pas & Advil for relief.

MedDRA releases: 2024-11 · check-in free text available
2022-11-05
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-11-14
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-19
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2023-01-07
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-04-08
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-26	Moderna	No
2	2021-04-23	Moderna	No
3	2021-11-05	Moderna	No
4	2022-10-08	Moderna	No

Free text

Release 10 — days 1–6 daily, dose 3

2021-11-06

Systemic reaction (other): Muscle weakness

Release 11 — 3 months, dose 3

2022-02-04

Symptoms: Sinus congestion started late Dec 2021 followed by tinnitus in left ear. Have used ear plug to minimize ringing. Ringing minimal upon waking however increases by late afternoon to evening.

Release 12 — days 1–6 daily, dose 4

2022-10-10

Systemic reaction (other): Severe Neck & upper shoulder pain

2022-10-11

Systemic reaction (other): Neck & shoulder pain moderate difficulty turning head side to side

2022-10-13

Systemic reaction (other): Nerve pains in both legs predominantly in upper thighs making simple walking difficult

2022-10-14

Systemic reaction (other): Continued Muscle inflammation leading to nerve pain in both thighs impacting ability to walk. Took one 200mg Advil in morning, now 6 hrs later walking comfortably.

Release 12 — day 14, dose 4

2022-10-23

Symptoms: Nausea sporadic, intermittent headaches over the past 7 days.

Release 12 — day 21, dose 4

2022-10-29

Symptoms: Nerve muscle pain makes walking difficult, using heated therma pak, salon pas & Advil for relief.

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	Gait disturbance	·	·	✓
SD	Headache	·	·	✓
SD	Myalgia	·	·	✓
SD	Nausea	·	·	✓
SD	Neuralgia	·	·	✓
SD	Self-medication	·	·	✓
SD	Sinus congestion	·	·	✓
SD	Tinnitus	·	·	✓
SRO	Arthralgia	·	·	✓
SRO	Gait disturbance	·	·	✓
SRO	Gait inability	·	·	✓
SRO	Mobility decreased	·	·	✓
SRO	Muscular weakness	·	·	✓
SRO	Myositis	·	·	✓
SRO	Neck pain	·	·	✓
SRO	Neuralgia	·	·	✓
SRO	Self-medication	·	·	✓

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