3TX-28487-23919

2 vaccinations 5 coded responses 17 check-ins 5 free-text entries 7 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 787 / TX
Registered: 2021-03-13

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

2021-03-13
Registered in v-safe
2021-03-13
Dose 1 — Moderna
2021-03-31
Survey response — day 14, dose 1
MedDRA: Back pain, COVID-19, Constipation, Diarrhoea, Headache, Vomiting — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: All since Covid, 01/20/2921...1. Lower back pain worsening by the day. Seeing pain Mngt Dr. 2. Raging headaches, 24/7. In consultation with PCP and neurologist.3. Vomiting and diarrhea/constipation worsening. Seeing Gastro-Inter Dr.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Report sent to call center — day 14, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-03
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-10
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-04-17
Dose 2 — Moderna
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Adult check-in
2021-04-20
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-24
Health check-in — day 7, dose 2
Feeling: Fair · Joint pains, Fatigue or tiredness, Diarrhea · Be unable to work, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Adult check-in
2021-04-24
Report sent to call center — day 7, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-01
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-08
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-17
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-23
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-29
Survey response — day 42, dose 2
MedDRA: Anorectal discomfort, Ear discomfort, Eye irritation, Eyelid irritation, Gingival discomfort, Headache, Mucosal inflammation, Nasal discomfort, Office visit, Oral discomfort, Throat irritation, Unevaluable event — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Inflammation in all mucous membranes. That is, burning in throat, eyes, eyelids, ears, nose, nostrils, gums, Inner cheeks, vulva area, rectum. Crashing headaches. I have failed to mention this to you, but have sought medical intervention from doctors · Healthcare visit (other): Colonoscopy, endoscopy, brain MRI.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-29
Report sent to call center — day 42, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-17
Survey response — 3 months, dose 2
MedDRA: Immune system disorder, Office visit, Pharyngitis streptococcal, Scarlet fever, Staphylococcal infection — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I developed a staph infection, strep throat and Scarlet Fever! I have no idea how so, because I Have ONLY been to a doctor offices, and I always wear a mask. I know I have a compromised immune system. Therefore, I am curious about a third injection.

MedDRA releases: 2024-11 · check-in free text available
2021-07-17
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-08-02
Call 1 — Could Not Reach Participant
2021-08-02
Call 1 — Could Not Reach Participant
2021-08-02
Call 1 — Could Not Reach Participant
2021-08-02
Call 1 — Could Not Reach Participant
2021-08-02
Call 1 — Could Not Reach Participant
2021-08-17
Call 2 — Could Not Reach Participant
2021-08-17
Call 2 — Could Not Reach Participant
2021-08-17
Call 2 — Could Not Reach Participant
2021-08-17
Call 2 — Could Not Reach Participant
2021-08-17
Call 2 — Could Not Reach Participant
2021-10-16
Survey response — 6 months, dose 2
MedDRA: Injury, Joint surgery, Lumbar vertebral fracture, Office visit, Thoracic vertebral fracture — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Back is broken at L1 - T12Buy a physical therapist with Encompass. Within a couple of weeks, I will have a massive surgery from L1 to the thoracic spine and all the way up through T3. Only one month ago, I had a right SI-joint fusion surgery. · Healthcare visit (other): In office visits with two spine surgeons and one pain management doctor.

MedDRA releases: 2024-11 · check-in free text available
2021-10-16
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-20
Call 1 — Could Not Reach Participant
2021-10-26
Call 2 — Could Not Reach Participant
2022-04-17
Survey response — 12 months, dose 2
MedDRA: Bedridden, Spinal disorder, Spinal fracture, Spinal operation — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Continued collapse of my spine, with massive surgery. After a physical therapist broke my back, 10 days after another major surgery. This renders me in bed, and with no social interaction and no Covid symptoms.

MedDRA releases: 2024-11 · check-in free text available
2022-04-17
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-04-20
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-13	Moderna
2	2021-04-17	Moderna

Call center

7 call center cases

7 unsuccessful

3 waits over 3 months for a first call

See the call center timeline

Free text

Release 6 — day 14, dose 1

2021-03-31

Symptoms: All since Covid, 01/20/2921...1. Lower back pain worsening by the day. Seeing pain Mngt Dr. 2. Raging headaches, 24/7. In consultation with PCP and neurologist.3. Vomiting and diarrhea/constipation worsening. Seeing Gastro-Inter Dr.

Release 8 — day 42, dose 2

2021-05-29

Symptoms: Inflammation in all mucous membranes. That is, burning in throat, eyes, eyelids, ears, nose, nostrils, gums, Inner cheeks, vulva area, rectum. Crashing headaches. I have failed to mention this to you, but have sought medical intervention from doctors cut off by CDC

Healthcare visit (other): Colonoscopy, endoscopy, brain MRI.

Release 9 — 3 months, dose 2

2021-07-17

Symptoms: I developed a staph infection, strep throat and Scarlet Fever! I have no idea how so, because I Have ONLY been to a doctor offices, and I always wear a mask. I know I have a compromised immune system. Therefore, I am curious about a third injection. cut off by CDC

Release 10 — 6 months, dose 2

2021-10-16

Symptoms: Back is broken at L1 - T12Buy a physical therapist with Encompass. Within a couple of weeks, I will have a massive surgery from L1 to the thoracic spine and all the way up through T3. Only one month ago, I had a right SI-joint fusion surgery.

Healthcare visit (other): In office visits with two spine surgeons and one pain management doctor.

Release 11 — 12 months, dose 2

2022-04-17

Symptoms: Continued collapse of my spine, with massive surgery. After a physical therapist broke my back, 10 days after another major surgery. This renders me in bed, and with no social interaction and no Covid symptoms.

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	Office visit	·	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Anorectal discomfort	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Bedridden	·	·	✓
SD	Constipation	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Ear discomfort	✓	✓	✓
SD	Eye irritation	✓	✓	✓
SD	Eyelid irritation	✓	✓	✓
SD	Gingival discomfort	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Immune system disorder	·	·	✓
SD	Injury	·	·	✓
SD	Joint surgery	·	·	✓
SD	Lumbar vertebral fracture	·	·	✓
SD	Mucosal inflammation	✓	✓	✓
SD	Nasal discomfort	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Oral discomfort	✓	✓	✓
SD	Pharyngitis streptococcal	·	·	✓
SD	Scarlet fever	·	·	✓
SD	Spinal disorder	·	·	✓
SD	Spinal fracture	·	·	✓
SD	Spinal operation	·	·	✓
SD	Staphylococcal infection	·	·	✓
SD	Thoracic vertebral fracture	·	·	✓
SD	Throat irritation	✓	✓	✓
SD	Vomiting	✓	✓	✓

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