3H9-11400-43819

2 vaccinations 7 coded responses 25 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 473 / IN
Registered: 2021-01-13

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

2021-01-13
Registered in v-safe
2021-01-13
Dose 1 — Moderna
2021-01-13
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: The pain at the injection site is mild during the day, but moderate with more discomfort at night.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-20
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Survey response — day 14, dose 1
MedDRA: Epistaxis, Hypertension — Feeling: Fair

Free text: Woke up with a nosebleed this morning. Blood pressure is higher than it usually is.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — day 21, dose 1
MedDRA: Blood pressure increased, Epistaxis, Medical counselling — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Blood pressure has been high, Dr. increased my meds. Had two nose bleeds this week. Dr. will see me in 2 weeks · Healthcare visit (other): Left message with nurse, she spoke with Dr.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-10
Dose 2 — Moderna
2021-02-10
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Joint pains · Be unable to do your normal daily activities

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · None · Be unable to do your normal daily activities

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: My left shoulder joint is sore and painful with use.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Injected limb mobility decreased, Product administered at inappropriate site — Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I am still having problems using my left arm. She put the injection high on the arm almost in the shoulder joint.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Survey response — days 1–6 daily, dose 2
MedDRA: Pain in extremity, Periarthritis, Product administered at inappropriate site — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: I am a RN, I do not think all of the pain in my left arm is vaccine related. I think the woman who gave me the vaccine missed the muscle in my upper arm and inserted the vaccine in the joint. My left arm now has all symptoms of a frozen shoulder. She placed the shot high above the muscle in my left upper arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — day 7, dose 2
MedDRA: Pain in extremity — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I am still having problems/pain with left arm, although it is a somewhat less painful today. The pain started just below the injection site(which I believe was injected into the wrong spot on my left arm).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-06-24
Call 1 — Left Voicemail
2021-08-11
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Moderna
2	2021-02-10	Moderna

Call center

1 call center case

1 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): The pain at the injection site is mild during the day, but moderate with more discomfort at night.

Release 2 — day 14, dose 1

2021-01-27

Symptoms: Woke up with a nosebleed this morning. Blood pressure is higher than it usually is.

Release 3 — day 21, dose 1

2021-02-03

Symptoms: Blood pressure has been high, Dr. increased my meds. Had two nose bleeds this week. Dr. will see me in 2 weeks

Healthcare visit (other): Left message with nurse, she spoke with Dr.

Release 4 — days 1–6 daily, dose 2

2021-02-14

Systemic reaction (other): My left shoulder joint is sore and painful with use.

2021-02-15

Systemic reaction (other): I am still having problems using my left arm. She put the injection high on the arm almost in the shoulder joint.

2021-02-16

Systemic reaction (other): I am a RN, I do not think all of the pain in my left arm is vaccine related. I think the woman who gave me the vaccine missed the muscle in my upper arm and inserted the vaccine in the joint. My left arm now has all symptoms of a frozen shoulder. She placed the shot high above the muscle in my left upper arm.

Release 4 — day 7, dose 2

2021-02-17

Systemic reaction (other): I am still having problems/pain with left arm, although it is a somewhat less painful today. The pain started just below the injection site(which I believe was injected into the wrong spot on my left arm).

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	Medical counselling	✓	✓	✓
SD	Blood pressure increased	✓	✓	✓
SD	Epistaxis	✓	✓	✓
SD	Hypertension	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Injected limb mobility decreased	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Periarthritis	✓	✓	✓
SRO	Product administered at inappropriate site	✓	✓	✓

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