4DL-19876-54246

Timeline

1. 2021-03-06
   Dose 1 — Moderna
2. 2021-03-23
   Registered in v-safe
3. 2021-03-23
   Health check-in — day 14, dose 1

   Feeling: Good

   Adult check-in
4. 2021-03-28
   Health check-in — day 21, dose 1

   Feeling: Good

   Adult check-in
5. 2021-04-03
   Dose 2 — Moderna
6. 2021-04-12
   Health check-in — day 7, dose 2

   Feeling: Good · Site: Pain · None

   Adult check-in
7. 2021-04-17
   Survey response — day 14, dose 2

   MedDRA: Back pain — Feeling: Good · Be unable to do your normal daily activities

   Free text: Lower back ache it just was for one day

   MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
8. 2021-04-24
   Survey response — day 21, dose 2

   MedDRA: Back pain — Feeling: Good · Be unable to do your normal daily activities

   Free text: Lower back ache

   MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
9. 2021-05-04
   Survey response — day 28, dose 2

   MedDRA: Abdominal discomfort, Back pain, Physiotherapy — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

   Free text: Symptoms: Lower back ache is better mild problem with stomach · Healthcare visit (other): Therapy for lower back

   MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
10. 2021-05-04
    Report sent to call center — day 28, dose 2

    Get care from a doctor or other healthcare professional

    1 call case(s)
11. 2021-05-10
    Survey response — day 35, dose 2

    MedDRA: Adverse reaction — Feeling: Good · Be unable to do your normal daily activities

    Free text: Problem with right knee comes and goes

    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
12. 2021-05-15
    Survey response — day 42, dose 2

    MedDRA: Abdominal tenderness, Nausea, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

    Free text: Symptoms: Stomach Nausea and and stomach tender · Healthcare visit (other): Primary doctor she sent me to get an ultra sound of my stomach

    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
13. 2021-05-15
    Report sent to call center — day 42, dose 2

    Get care from a doctor or other healthcare professional

    1 call case(s)
14. 2021-07-05
    Survey response — 3 months, dose 2

    MedDRA: Haemorrhoids, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

    Free text: Symptoms: I developed a fungus on either side of my but it is small. Butt I have to be careful because I have hemorrhoids and it is hard to put the nystatin cream on the fungusI started to use cream 6/24/21Until it s all globe hopefully by thenThe fungus · Healthcare visit (other): Primary physician

    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
15. 2021-07-05
    Report sent to call center — 3 months, dose 2

    Get care from a doctor or other healthcare professional

    1 call case(s)
16. 2021-07-08
    Call successful

    Does not wish to fill out VAERS report
17. 2021-10-05
    Survey response — 6 months, dose 2

    MedDRA: Abnormal dreams, Arthralgia, Erythema, Palmar erythema, Pruritus — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

    Free text: Pain in right shoulder I had flu shot 9/16/21 pain shoulder started 5 days after shot. I do have dreams occasionally not like when I first had Covid shot. Also left palm hand itching goes red

    MedDRA releases: 2024-11 · check-in free text available
18. 2021-10-05
    Report sent to call center — 6 months, dose 2

    Get care from a doctor or other healthcare professional

    Outpatient clinic or urgent care clinic visit · 1 call case(s)
19. 2021-10-07
    Call successful

    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
20. 2022-04-03
    Survey response — 12 months, dose 2

    MedDRA: Arterial repair, Office visit, Rash — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

    Free text: Symptoms: Surgery left caroused arterty. I also have a rash on both sides of my butt since June and my primary doctor as tried me on 3 different creams but they haven't got rid of the rash. · Healthcare visit (other): For surgery carotid artery's. Had to

    MedDRA releases: 2024-11 · check-in free text available
21. 2022-04-03
    Report sent to call center — 12 months, dose 2

    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

    Hospitalization · 1 call case(s)
22. 2022-04-04
    Call 1 — Left Voicemail
23. 2022-04-04
    Call successful

    Participant prefers to complete VAERS report online