4DT-32178-36873

3 vaccinations 13 coded responses 23 check-ins 13 free-text entries 5 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 074 / NJ
Registered: 2021-01-07

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

2021-01-07
Registered in v-safe
2021-01-07
Dose 1 — Moderna
2021-01-07
Survey response — day 0, dose 1
MedDRA: Abdominal discomfort — Feeling: Good

Free text: Slight abdominal discomfort

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Abdominal pain, Rash, not including the immediate area around the injection site

Adult check-in
2021-01-09
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Oedema peripheral, Rash — Feeling: Good · Joint pains

Free text: Joint pain and mild edema on my right hand only for couple of hours .... I had the rash on my right side of jaw only for couple of hours yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-01-17
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-28
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-04
Dose 2 — Moderna
2021-02-06
Health check-in — days 1–6 daily, dose 2
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

Adult check-in
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Groin pain, Pain in extremity — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Nausea · Be unable to work

Free text: Severe pain in the lower back, groin and upper leg

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Groin pain, Pain in extremity — Feeling: Fair · Site: Pain, Swelling · Fever · Joint pains, Muscle or body aches

Free text: Pain in lower back, groin, and upper leg

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Groin pain, Pain in extremity — Feeling: Good · Joint pains

Free text: Pain in lower back, groin and upper leg

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-18
Survey response — day 14, dose 2
MedDRA: Groin pain, Pain in extremity — Feeling: Fair

Free text: Extreme pain in my groin and upper leg area, as if I've worked out, but I didn't.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Survey response — day 21, dose 2
MedDRA: Back pain, Gingival bleeding, Gingival hypertrophy, Groin pain, Nausea, Pain in extremity — Feeling: Good

Free text: Gingiva hyperplasia and bleeding gums + pain in the lower back, groin, and upper leg, in addition, to feeling nauseous.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — day 28, dose 2
MedDRA: Arthralgia — Feeling: Fair

Free text: Pain in left hip and knee - which started this afternoon but progressively got worse to now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Survey response — day 35, dose 2
MedDRA: Arthralgia, Muscle spasms, Office visit, Pain in extremity — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Pain in my joints, hip and knee the left leg for one week and cramping right foot multiple times today. · Healthcare visit (other): Doctor visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-06
Survey response — 3 months, dose 2
MedDRA: Blood test, Pain in extremity, X-ray — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Extreme pain in my left leg with shooting pain to my toes. · Healthcare visit (other): X-rays, blood work

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-07
Survey response — 6 months, dose 2
MedDRA: Office visit, Pain, Pain in extremity, Skin discolouration — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Shooting pain in second left toe following with the same symptoms on the right second toe. Both toes got discolored to black and blue. · Healthcare visit (other): In person visit

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-07
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-12
Call 2 — Left Voicemail
2021-11-28
Dose 3 — Moderna
2022-02-04
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-29
Survey response — 6 months, dose 3
MedDRA: Contusion, Musculoskeletal chest pain, Pain — Feeling: Fair · Be unable to work or attend school, 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: Sudden excruciating pain by lower right side rib cage. CAT scan, X-rays, CBC, ultrasound all with negative results; no gallstone, no liver and no pancreatitis. A few days after had bruises on my left leg, left arm and left buttock. I'm im pain.

MedDRA releases: 2024-11 · check-in free text available
2022-05-29
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · 1 call case(s)
2022-05-31
Call 1 — Left Voicemail
2022-05-31
Call 1 — Left Voicemail
2022-05-31
Call 1 — Left Voicemail
2022-05-31
Call 1 — Left Voicemail
2022-11-28
Survey response — 12 months, dose 3
MedDRA: Alopecia, Eczema, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Thinning hair and eczema on my skin · Healthcare visit (other): Blood work

MedDRA releases: 2024-11 · check-in free text available
2022-11-28
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-11-29
Call 2 — Left Voicemail
2022-11-29
Call 2 — Left Voicemail
2022-11-29
Call 3 — Left Voicemail
2022-11-29
Call 2 — Left Voicemail
2022-11-29
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-04	Moderna
3	2021-11-28	Moderna	No

Call center

5 call center cases

5 unsuccessful

2 waits over 3 months for a first call

See the call center timeline

Free text

Release 1 — day 0, dose 1

2021-01-07

Systemic reaction (other): Slight abdominal discomfort

Release 1 — days 1–6 daily, dose 1

2021-01-09

Systemic reaction (other): Joint pain and mild edema on my right hand only for couple of hours .... I had the rash on my right side of jaw only for couple of hours yesterday

Release 3 — days 1–6 daily, dose 2

2021-02-07

Systemic reaction (other): Severe pain in the lower back, groin and upper leg

2021-02-08

Systemic reaction (other): Pain in lower back, groin, and upper leg

2021-02-09

Systemic reaction (other): Pain in lower back, groin and upper leg

Release 4 — day 14, dose 2

2021-02-18

Symptoms: Extreme pain in my groin and upper leg area, as if I've worked out, but I didn't.

Release 4 — day 21, dose 2

2021-02-27

Symptoms: Gingiva hyperplasia and bleeding gums + pain in the lower back, groin, and upper leg, in addition, to feeling nauseous.

Release 5 — day 28, dose 2

2021-03-04

Symptoms: Pain in left hip and knee - which started this afternoon but progressively got worse to now.

Release 5 — day 35, dose 2

2021-03-13

Symptoms: Pain in my joints, hip and knee the left leg for one week and cramping right foot multiple times today.

Healthcare visit (other): Doctor visit

Release 8 — 3 months, dose 2

2021-05-06

Symptoms: Extreme pain in my left leg with shooting pain to my toes.

Healthcare visit (other): X-rays, blood work

Release 9 — 6 months, dose 2

2021-08-07

Symptoms: Shooting pain in second left toe following with the same symptoms on the right second toe. Both toes got discolored to black and blue.

Healthcare visit (other): In person visit

Release 11 — 6 months, dose 3

2022-05-29

Symptoms: Sudden excruciating pain by lower right side rib cage. CAT scan, X-rays, CBC, ultrasound all with negative results; no gallstone, no liver and no pancreatitis. A few days after had bruises on my left leg, left arm and left buttock. I'm im pain.

Release 12 — 12 months, dose 3

2022-11-28

Symptoms: Thinning hair and eczema on my skin

Healthcare visit (other): Blood work

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	Blood test	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Unevaluable event	·	·	✓
HCVO	X-ray	✓	✓	✓
SD	Alopecia	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Contusion	·	·	✓
SD	Eczema	·	·	✓
SD	Gingival bleeding	✓	✓	✓
SD	Gingival hypertrophy	✓	✓	✓
SD	Groin pain	✓	✓	✓
SD	Joint dislocation	○	·	○
SD	Muscle spasms	✓	✓	✓
SD	Musculoskeletal chest pain	·	·	✓
SD	Nausea	✓	✓	✓
SD	Pain	✓	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Skin discolouration	✓	·	✓
SRO	Abdominal discomfort	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Groin pain	✓	✓	✓
SRO	Oedema peripheral	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Rash	✓	✓	✓

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