4FK-13976-03762
2 vaccinations
4 coded responses
17 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 053 / VT
- Registered
- 2021-01-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-04
Registered in v-safe
-
2021-01-04
Dose 1 — Moderna
-
2021-01-04
Health check-in — day 0, dose 1Feeling: Good · Site: Pain · Headache, Muscle or body achesAdult check-in
- 2021-01-05
- 2021-01-06
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-18
- 2021-01-25
-
2021-02-01
Dose 2 — Moderna
-
2021-02-04
Survey response — days 1–6 daily, dose 2MedDRA: Adverse reaction — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesFree text: I did not get a check in after I verified I received my 2nd dose. I had significant side effects on 2/2.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-05
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia — Feeling: Fair · Site: Redness, Swelling · Joint pains, Muscle or body achesFree text: Since the day after, I have had pain in my shoulder joint and over into my shoulder blade. It still hurts when I take a deep breath from the right side of my chest right through to my shoulder blade.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-06
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia, Chest pain — Feeling: Good · Site: Redness · Headache, Joint pains, Muscle or body achesFree text: Still having pain deep in upper right chest, shoulder joint and blade when I take a deep breath but improvingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-07
-
2021-02-09
Survey response — day 7, dose 2MedDRA: Dyspnoea — Feeling: Good · Joint pains, Fatigue or tirednessFree text: Still having trouble taking a deep breath.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-17
- 2021-03-17
- 2021-08-04
- 2022-02-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-04 | Moderna | |
| 2 | 2021-02-01 | Moderna |
Free text
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): I did not get a check in after I verified I received my 2nd dose. I had significant side effects on 2/2.
Systemic reaction (other): Since the day after, I have had pain in my shoulder joint and over into my shoulder blade. It still hurts when I take a deep breath from the right side of my chest right through to my shoulder blade.
Systemic reaction (other): Still having pain deep in upper right chest, shoulder joint and blade when I take a deep breath but improving
Release 3 — day 7, dose 2
Systemic reaction (other): Still having trouble taking a deep breath.
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 |
|---|---|---|---|---|
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Chest pain | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release