3Z6-15486-41578

2 vaccinations 9 coded responses 23 check-ins 9 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 240 / VA
Registered: 2021-01-06

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline

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

2021-01-06
Registered in v-safe
2021-01-06
Dose 1 — Moderna
2021-01-06
Survey response — day 0, dose 1
MedDRA: Therapeutic response unexpected — Feeling: Good

Free text: My headache is gone that I had all day before the vaccination!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-01-10
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Tenderness — Feeling: Fair · Joint pains

Free text: Nerve tenderness on left wrist painful to touch

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-11
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Neuralgia — Feeling: Fair · Joint pains

Free text: Still have nerve pain left wrist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Health check-in — day 7, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-01-21
Survey response — day 14, dose 1
MedDRA: Back pain, Physiotherapy — Feeling: Fair · 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: Symptoms: Back psi · Healthcare visit (other): Going to physical therapy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-27
Survey response — day 21, dose 1
MedDRA: Back pain, Physiotherapy — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Back pain in left to ckavicle · Healthcare visit (other): Physical therapy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Report sent to call center — day 21, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-03
Dose 2 — Moderna
2021-02-03
Survey response — day 0, dose 2
MedDRA: Pain — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Pain still in left clavicle rotator area since 1st fose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-02-07
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
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Mobility decreased, Pain in extremity, Physiotherapy — Feeling: Good · Site: Pain, Swelling · 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

Free text: Systemic reaction (other): Opposite arm still pain limited rom since 1st shot in opposite arm · Healthcare visit (other): Physical therapy today for joint clavicle left arm never injected hurts since 1st shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
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)
2021-02-09
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Pain, Swelling — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Neck is swollen, still have a pain on left shoulder and clavicle

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — day 7, dose 2
MedDRA: Arthralgia, Neck pain — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Pain in left clavicle upper arm joint, neck left pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-02-26
Health check-in — day 21, dose 2
Feeling: Good

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

Adult check-in
2021-03-15
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-17
Health check-in — day 42, dose 2
Feeling: Fair

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

Adult check-in
2021-05-17
Call 1 — Left Voicemail
2021-08-05
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-06	Moderna
2	2021-02-03	Moderna

Call center

3 call center cases

3 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 1 — day 0, dose 1

2021-01-06

Systemic reaction (other): My headache is gone that I had all day before the vaccination!

Release 1 — days 1–6 daily, dose 1

2021-01-10

Systemic reaction (other): Nerve tenderness on left wrist painful to touch

2021-01-11

Systemic reaction (other): Still have nerve pain left wrist

Release 2 — day 14, dose 1

2021-01-21

Symptoms: Back psi

Healthcare visit (other): Going to physical therapy

Release 2 — day 21, dose 1

2021-01-27

Symptoms: Back pain in left to ckavicle

Healthcare visit (other): Physical therapy

Release 3 — day 0, dose 2

2021-02-03

Systemic reaction (other): Pain still in left clavicle rotator area since 1st fose

Release 3 — days 1–6 daily, dose 2

2021-02-08

Systemic reaction (other): Opposite arm still pain limited rom since 1st shot in opposite arm

Healthcare visit (other): Physical therapy today for joint clavicle left arm never injected hurts since 1st shot

2021-02-09

Systemic reaction (other): Neck is swollen, still have a pain on left shoulder and clavicle

Release 4 — day 7, dose 2

2021-02-10

Systemic reaction (other): Pain in left clavicle upper arm joint, neck left pain

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	Physiotherapy	✓	✓	✓
SD	Back pain	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Mobility decreased	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Neuralgia	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Swelling	✓	✓	✓
SRO	Tenderness	✓	✓	✓
SRO	Therapeutic response unexpected	✓	✓	✓

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