455-13065-13487

3 vaccinations 9 coded responses 19 check-ins 9 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 847 / UT
Registered: 2021-02-07

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

2021-02-04
Dose 1 — Moderna
2021-02-07
Registered in v-safe
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Swelling · Chills, Joint pains, Muscle or body aches

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-09
Survey response — days 1–6 daily, dose 1
MedDRA: Nausea, Rash — Feeling: Fair · Chills, Joint pains, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site

Free text: Rash is on my thigh. I had nausea at 5pm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-11
Survey response — day 7, dose 1
MedDRA: Nausea — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Nauseated all day...

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-25
Survey response — day 21, dose 1
MedDRA: Pain, Pre-existing disease, Rheumatoid arthritis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Overall body pain. I think its a Rheumatoid arthritis flare up. Im concerned about getting the second vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — day 28, dose 1
MedDRA: Back pain, Neck pain, Pain, Pain in extremity, Pre-existing disease, Rheumatoid arthritis — Feeling: Fair · Be unable to do your normal daily activities

Free text: RA flare up. Pain all over. Feet, legs, hands, arms, neck and back pain. I get the second vaccine Tuesday, March 9th. Im really nervous about getting the second vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Dose 2 — Moderna
2021-03-18
Survey response — day 7, dose 2
MedDRA: No adverse event — Feeling: Fair · Site: Redness · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: I also had my first Humira injection on Monday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-06
Survey response — day 28, dose 2
MedDRA: Kidney infection, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Kidney infection · Healthcare visit (other): My general doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-13
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-20
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-08
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-25
Dose 3 — Moderna
2021-09-07
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-11-24
Survey response — 3 months, dose 3
MedDRA: Heart rate increased, Palpitations, Protein urine — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Palpitations and rapid heart rate. Wearing holter monitor. High levels of protein in urine.

MedDRA releases: 2024-11 · check-in free text available
2021-11-24
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-13
Call successful
Not applicable - Accidental Reporting
2022-01-13
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-02-25
Survey response — 6 months, dose 3
MedDRA: Giant cell arteritis, Office visit, Polymyalgia rheumatica, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Symptoms: Temporal Artetitis (Giant Cell) Polymyalgia Rheumatica flare up. · Healthcare visit (other): Doctor office

MedDRA releases: 2024-11 · check-in free text available
2022-02-25
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2022-03-02
Call 1 — Left Voicemail
2022-08-27
Survey response — 12 months, dose 3
MedDRA: Atrial fibrillation, Giant cell arteritis — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: AFIB and Giant Cell Arteritis

MedDRA releases: 2024-11 · check-in free text available
2022-08-27
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-08-29
Call 2 — Requested Callback
2022-08-29
Call 1 — Requested Callback
2022-08-31
Callback requested for
01:00PM ET
2022-09-01
Call 3 — Left Voicemail
2022-09-01
Call 2 — Left Voicemail
2022-09-09
Call successful
Not applicable - Accidental Reporting
2022-09-09
Call successful
Not applicable - Accidental Reporting

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-04	Moderna
2	2021-03-09	Moderna
3	2021-08-25	Moderna	No

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-09

Systemic reaction (other): Rash is on my thigh. I had nausea at 5pm.

Release 4 — day 7, dose 1

2021-02-11

Systemic reaction (other): Nauseated all day...

Release 4 — day 21, dose 1

2021-02-25

Symptoms: Overall body pain. I think its a Rheumatoid arthritis flare up. Im concerned about getting the second vaccine.

Release 5 — day 28, dose 1

2021-03-04

Symptoms: RA flare up. Pain all over. Feet, legs, hands, arms, neck and back pain. I get the second vaccine Tuesday, March 9th. Im really nervous about getting the second vaccine.

Release 5 — day 7, dose 2

2021-03-18

Systemic reaction (other): I also had my first Humira injection on Monday.

Release 7 — day 28, dose 2

2021-04-06

Symptoms: Kidney infection

Healthcare visit (other): My general doctor

Release 10 — 3 months, dose 3

2021-11-24

Symptoms: Palpitations and rapid heart rate. Wearing holter monitor. High levels of protein in urine.

Release 11 — 6 months, dose 3

2022-02-25

Symptoms: Temporal Artetitis (Giant Cell) Polymyalgia Rheumatica flare up.

Healthcare visit (other): Doctor office

Release 12 — 12 months, dose 3

2022-08-27

Symptoms: AFIB and Giant Cell Arteritis

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	✓	✓	✓
SD	Atrial fibrillation	·	·	✓
SD	Back pain	✓	✓	✓
SD	Giant cell arteritis	·	·	✓
SD	Heart rate increased	·	·	✓
SD	Kidney infection	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Palpitations	·	·	✓
SD	Polymyalgia rheumatica	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Protein urine	·	·	✓
SD	Rheumatoid arthritis	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Rash	✓	✓	✓

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