3RW-17120-00518
5 vaccinations
8 coded responses
44 check-ins
8 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 317 / GA
- Registered
- 2021-01-18
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-18
Registered in v-safe
-
2021-01-18
Dose 1 — Moderna
- 2021-01-18
- 2021-01-24
- 2021-01-25
- 2021-02-01
- 2021-02-08
-
2021-02-13
Dose 2 — Moderna
-
2021-02-14
Survey response — days 1–6 daily, dose 2MedDRA: Pain in extremity — Feeling: Good · Site: PainFree text: Mild aches on the injection armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-15
-
2021-02-16
Survey response — days 1–6 daily, dose 2MedDRA: Musculoskeletal chest pain — Feeling: Fair · Muscle or body achesFree text: Probably not related but have aches/pain on right side of body ribs, by my right arm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-17
Survey response — days 1–6 daily, dose 2MedDRA: Back pain — Feeling: Good · Muscle or body achesFree text: Back and side pain but problems not related to shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-18
Survey response — days 1–6 daily, dose 2MedDRA: Back pain, Flank pain — Feeling: GoodFree text: Side and back pain but probably not relatedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-19
Survey response — days 1–6 daily, dose 2MedDRA: Abdominal pain, Back pain, Breast pain — Feeling: GoodFree text: I dont know if what I felt the last few days are related to the shot. Back, side and under my right breast pain.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-20
Survey response — day 7, dose 2MedDRA: Pain — Feeling: GoodFree text: Same pain not as badMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-28
- 2021-03-06
- 2021-03-13
- 2021-03-20
- 2021-03-27
- 2021-05-15
- 2021-08-14
-
2021-11-03
Dose 3 — Moderna
- 2022-02-13
-
2022-04-19
Dose 4 — Moderna
-
2022-04-20
Survey response — days 1–6 daily, dose 4MedDRA: Injection site pain, Pain in extremity — Feeling: Good · Site: Pain · Fever · Muscle or body achesFree text: Arm more sore than actual pain at the injection site.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-21
Survey response — days 1–6 daily, dose 4MedDRA: Neck mass, Pain — Feeling: Good · Site: PainFree text: Don't know if it is related, but a lump in y neck seems to have reappeared and a ittle sore.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-28
- 2022-05-03
- 2022-05-12
- 2022-05-17
- 2022-05-24
- 2022-05-31
- 2022-07-21
-
2022-10-20
Dose 5 — Moderna
- 2022-10-20
- 2022-10-20
- 2022-10-21
- 2022-10-22
- 2022-10-23
- 2022-10-24
- 2022-10-26
- 2022-10-28
- 2022-11-03
- 2022-11-11
- 2022-11-20
- 2022-11-26
- 2022-12-02
- 2023-01-21
- 2023-04-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-18 | Moderna | |
| 2 | 2021-02-13 | Moderna | |
| 3 | 2021-11-03 | Moderna | No |
| 4 | 2022-04-19 | Moderna | No |
| 5 | 2022-10-20 | Moderna | No |
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Mild aches on the injection arm
Systemic reaction (other): Probably not related but have aches/pain on right side of body ribs, by my right arm.
Systemic reaction (other): Back and side pain but problems not related to shot
Systemic reaction (other): Side and back pain but probably not related
Systemic reaction (other): I dont know if what I felt the last few days are related to the shot. Back, side and under my right breast pain.
Release 4 — day 7, dose 2
Systemic reaction (other): Same pain not as bad
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Arm more sore than actual pain at the injection site.
Systemic reaction (other): Don't know if it is related, but a lump in y neck seems to have reappeared and a ittle sore.
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 |
|---|---|---|---|---|
| SRO | Abdominal pain | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Breast pain | ✓ | ✓ | ✓ |
| SRO | Flank pain | ✓ | ✓ | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Musculoskeletal chest pain | ✓ | ✓ | ✓ |
| SRO | Neck mass | · | · | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release