4BB-33350-52803

4 vaccinations 8 coded responses 34 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 973 / OR
Registered: 2020-12-23

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Registered dependents

M6J-25581-35724 Child or adolescent in my care · Male · 2022-01-06

98V-33312-83615 Child or adolescent in my care · Male · 2022-01-06

Timeline

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

2020-12-23
Registered in v-safe
2020-12-23
Dose 1 — Moderna
2020-12-23
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-25
Survey response — days 1–6 daily, dose 1
MedDRA: Injected limb mobility decreased, Injection site pain, Joint range of motion decreased, Loss of personal independence in daily activities, Muscular weakness, Myalgia — Feeling: Fair · Site: Pain · Be unable to do your normal daily activities

Free text: My deltoid is very sore (more than any other vaccine I've received). I also have restricted range of motion and weakness related to the pain. Brushing my hair was nearly impossible this morning. It's almost like an early frozen shoulder. Otherwise I feel great.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-25
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2020-12-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2020-12-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-13
Survey response — day 21, dose 1
MedDRA: Chills, Fatigue, Headache, Human rhinovirus test positive, Influenza like illness, Nasal congestion, Oropharyngeal pain, Pain, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work

Free text: Developed mild flu like symptoms 1/9/21- body aches, chills, headache, fatigue, nasal congestion, runny nose, sore throat. Got tested- COVID-19 negative, positive for rhinovirus. Today I feel better but still with nasal congestion.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Report sent to call center — day 21, dose 1
Be unable to work

1 call case(s)
2021-01-18
Dose 2 — Moderna
2021-01-19
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Nausea

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-27
Survey response — day 7, dose 2
MedDRA: Menstruation delayed — Feeling: Good

Free text: Missed period, but not sure if it is related (not pregnant, husband has vasectomy)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-09
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-22
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-01
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-19
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Erythema, Pain, Pre-existing disease, Rash pruritic, Swelling — Feeling: Good

Free text: I developed probably before the last check-in some arthritis type symptoms- bilateral knee pain, pain, swelling, and redness of 3/10 distal interphalangeal joints, itchy rashes on the affected joints.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-19
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-10
Dose 3 — Moderna
2022-02-09
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-10-05
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-10-07
Survey response — days 1–6 daily, dose 4
MedDRA: Fatigue, Headache, Nausea, Pain, Pyrexia — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: 16-18 hours after the vaccine, I did experience fever, body aches, fatigue, headache, nausea

MedDRA releases: 2024-11 · check-in free text available
2022-10-08
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-10-09
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-10-12
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-10-20
Survey response — day 14, dose 4
MedDRA: Depressed mood — Feeling: Fair

Free text: Feeling a bit more depressed

MedDRA releases: 2024-11 · check-in free text available
2022-10-26
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-04
Survey response — day 28, dose 4
MedDRA: Depressed mood, Headache — Feeling: Fair

Free text: I realized that I had a headache daily for about a week that was unusual for me. It's now resolved. Also, I feel more depressed, but this could be the weather change to winter.

MedDRA releases: 2024-11 · check-in free text available
2022-11-11
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-16
Survey response — day 42, dose 4
MedDRA: Cough, Menstruation irregular, Nasal congestion, Rhinorrhoea — Feeling: Good

Free text: Nasal congestion, runny nose, mild cough, missed period

MedDRA releases: 2024-11 · check-in free text available
2023-01-07
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-04-05
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-23	Moderna
2	2021-01-18	Moderna
3	2021-11-10	Moderna	No
4	2022-10-05	Pfizer-BioNTech	Flu

Call center

2 call center cases

2 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-25

Systemic reaction (other): My deltoid is very sore (more than any other vaccine I've received). I also have restricted range of motion and weakness related to the pain. Brushing my hair was nearly impossible this morning. It's almost like an early frozen shoulder. Otherwise I feel great.

Release 1 — day 21, dose 1

2021-01-13

Symptoms: Developed mild flu like symptoms 1/9/21- body aches, chills, headache, fatigue, nasal congestion, runny nose, sore throat. Got tested- COVID-19 negative, positive for rhinovirus. Today I feel better but still with nasal congestion.

Release 2 — day 7, dose 2

2021-01-27

Systemic reaction (other): Missed period, but not sure if it is related (not pregnant, husband has vasectomy)

Release 7 — 3 months, dose 2

2021-04-19

Symptoms: I developed probably before the last check-in some arthritis type symptoms- bilateral knee pain, pain, swelling, and redness of 3/10 distal interphalangeal joints, itchy rashes on the affected joints.

Release 12 — days 1–6 daily, dose 4

2022-10-07

Systemic reaction (other): 16-18 hours after the vaccine, I did experience fever, body aches, fatigue, headache, nausea

Release 12 — day 14, dose 4

2022-10-20

Symptoms: Feeling a bit more depressed

Release 12 — day 28, dose 4

2022-11-04

Symptoms: I realized that I had a headache daily for about a week that was unusual for me. It's now resolved. Also, I feel more depressed, but this could be the weather change to winter.

Release 12 — day 42, dose 4

2022-11-16

Symptoms: Nasal congestion, runny nose, mild cough, missed period

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	Arthralgia	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Cough	·	·	✓
SD	Depressed mood	·	·	✓
SD	Erythema	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Human rhinovirus test positive	✓	✓	✓
SD	Influenza like illness	✓	✓	✓
SD	Menstruation irregular	·	·	✓
SD	Nasal congestion	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	SARS-CoV-2 test negative	✓	✓	✓
SD	Swelling	✓	✓	✓
SRO	Fatigue	·	·	✓
SRO	Headache	·	·	✓
SRO	Injected limb mobility decreased	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Joint range of motion decreased	✓	✓	✓
SRO	Loss of personal independence in daily activities	✓	✓	✓
SRO	Menstruation delayed	✓	✓	✓
SRO	Muscular weakness	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Nausea	·	·	✓
SRO	Pain	·	·	✓
SRO	Pyrexia	·	·	✓

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