47Y-22595-38469

3 vaccinations 10 coded responses 25 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 36-40
ZIP prefix: 986 / WA
Registered: 2021-05-26

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

AKH-94562-31402 Child or adolescent in my care · Male · 2022-06-04

Timeline

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

2021-05-25
Dose 1 — Moderna
2021-05-26
Registered in v-safe
2021-05-26
Survey response — days 1–6 daily, dose 1
MedDRA: Dry eye, Erythema, Pain in extremity, Paraesthesia oral — Feeling: Good · Site: Pain, Swelling · Chills, Headache, Joint pains, Rash, not including the immediate area around the injection site

Free text: My knuckles are red and sore, lips sometimes will tingle and eyes are dry

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain, Paraesthesia — Feeling: Fair · Site: Pain, Swelling, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Pins and needles on my whole left side (injection side) and low back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-05-29
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain, Hypoaesthesia — Feeling: Good · Be unable to do your normal daily activities

Free text: Not sure is this is from the vaccine but I had lower back pain and numbness in my legs again

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-05-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-06-01
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-06-08
Survey response — day 14, dose 1
MedDRA: Back pain, Emergency care, Flank pain, Hypoaesthesia — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: I went to the Emergency Room 06/02/2021 for severe pain in my left side and back. Sudden onset with left side numbness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-08
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)
2021-06-15
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-06-22
Dose 2 — Moderna
2021-06-22
Survey response — day 0, dose 2
MedDRA: Eye pain, Paraesthesia — Feeling: Good · Site: Pain

Free text: Left side of face tingled after and my left eye ball felt like a needle was going through it for the las 2.5 hours

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-23
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good · Site: Pain, Swelling

Free text: Mild sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Diarrhea

Adult check-in
2021-06-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-06-26
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia — Feeling: Good · Fatigue or tiredness, Diarrhea

Free text: Leg and foot numbness (more than usual)mild

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Diarrhea

Adult check-in
2021-06-28
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Back pain, Paraesthesia — Feeling: Good · Be unable to do your normal daily activities

Free text: Lower back left side achy, weakness in lower back with tingly legs same as after 1st shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-29
Health check-in — day 7, dose 2
Feeling: Good · Diarrhea

Adult check-in
2021-07-06
Survey response — day 14, dose 2
MedDRA: Injection site pain — Feeling: Good

Free text: My shot site was burning this morning.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-15
Survey response — day 21, dose 2
MedDRA: Chest discomfort, Dyspnoea, Fatigue, Oropharyngeal pain — Feeling: Fair

Free text: Sore throat, tight chest and hard to get a deep breath, tired

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-07-27
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-08-05
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-09-23
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-11
Call 1 — Left Voicemail
2021-12-21
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-30
Dose 3 — Moderna
2022-06-30
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-25	Moderna
2	2021-06-22	Moderna	No
3	2021-12-30	Moderna	No

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 8 — days 1–6 daily, dose 1

2021-05-26

Systemic reaction (other): My knuckles are red and sore, lips sometimes will tingle and eyes are dry

2021-05-27

Systemic reaction (other): Pins and needles on my whole left side (injection side) and low back pain

2021-05-29

Systemic reaction (other): Not sure is this is from the vaccine but I had lower back pain and numbness in my legs again

Release 8 — day 14, dose 1

2021-06-08

Symptoms: I went to the Emergency Room 06/02/2021 for severe pain in my left side and back. Sudden onset with left side numbness.

Release 9 — day 0, dose 2

2021-06-22

Systemic reaction (other): Left side of face tingled after and my left eye ball felt like a needle was going through it for the las 2.5 hours

Release 9 — days 1–6 daily, dose 2

2021-06-23

Systemic reaction (other): Mild sore throat

2021-06-26

Systemic reaction (other): Leg and foot numbness (more than usual)mild

2021-06-28

Systemic reaction (other): Lower back left side achy, weakness in lower back with tingly legs same as after 1st shot

Release 9 — day 14, dose 2

2021-07-06

Symptoms: My shot site was burning this morning.

Release 9 — day 21, dose 2

2021-07-15

Symptoms: Sore throat, tight chest and hard to get a deep breath, tired

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
SD	Back pain	✓	✓	✓
SD	Chest discomfort	✓	·	✓
SD	Dyspnoea	✓	·	✓
SD	Emergency care	✓	✓	✓
SD	Fatigue	✓	·	✓
SD	Flank pain	✓	✓	✓
SD	Hypoaesthesia	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Oropharyngeal pain	✓	·	✓
SRO	Asthenia	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Dry eye	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Eye pain	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Paraesthesia oral	✓	✓	✓

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