4L8-10463-00735

2 vaccinations 10 coded responses 16 check-ins 10 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 342 / FL
Registered: 2021-03-12

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

2021-03-10
Dose 1 — Moderna
2021-03-12
Registered in v-safe
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain, Pain in extremity — Feeling: Good · Headache

Free text: Lower back pain & pain on my he top of left foot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-15
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain, Pre-existing disease — Feeling: Good · Headache

Free text: Slight sore throat. The headaches I had before the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Good

Free text: Slight sore throat.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — day 7, dose 1
MedDRA: Arthralgia, Pain in extremity — Feeling: Fair · Headache, Muscle or body aches

Free text: I got the injection in my left arm & my shoulder & foot are really sore. Seems odd, but what do I know.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — day 14, dose 1
MedDRA: Headache, Oropharyngeal pain, Pain in extremity — Feeling: Good · Be unable to do your normal daily activities

Free text: Really bad pain in left foot. Headache & sore throat. No fever

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — day 21, dose 1
MedDRA: Abdominal pain upper, Fatigue, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Severe stomach cramps, exhaustion, low grade fever. It lasted 1 day, although I do feel more tired then normal today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Dose 2 — Moderna
2021-04-22
Survey response — day 7, dose 2
MedDRA: Hypersomnia, Malaise, Viral infection — Feeling: Good

Free text: For 3 days after 2nd shot I was sick as a dog. All my symptoms made me feel like I had a virus. Was in bed for 3 days. The symptoms started almost 24 hrs. After 2nd shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-15
Survey response — day 35, dose 2
MedDRA: Colitis, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: 2 severe colitis attacks. Ive had this condition for many years. I experienced this attacks quite frequently for several years. Havent had an attack like I did in 20 yrs.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
Survey response — day 42, dose 2
MedDRA: Colitis, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: My colitis has come back with a vengeance. I had it years ago., & now its back · Healthcare visit (other): On Monday. My primary Physician, to see what can be done.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-10
Survey response — 3 months, dose 2
MedDRA: Colitis, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: My colitis is back with a vengeance. Havent had an attack since 2016 & now ive had 5 in the last month. Dr. Is sending me to a gastroenterologist. · Healthcare visit (other): Primary Dr.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-10
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-16
Call 1 — Left Voicemail
2021-10-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-12
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-10	Moderna
2	2021-04-10	Moderna

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-13

Systemic reaction (other): Lower back pain & pain on my he top of left foot

2021-03-15

Systemic reaction (other): Slight sore throat. The headaches I had before the vaccine.

2021-03-16

Systemic reaction (other): Slight sore throat.

Release 5 — day 7, dose 1

2021-03-17

Systemic reaction (other): I got the injection in my left arm & my shoulder & foot are really sore. Seems odd, but what do I know.

Release 6 — day 14, dose 1

2021-03-24

Symptoms: Really bad pain in left foot. Headache & sore throat. No fever

Release 6 — day 21, dose 1

2021-04-01

Symptoms: Severe stomach cramps, exhaustion, low grade fever. It lasted 1 day, although I do feel more tired then normal today.

Release 7 — day 7, dose 2

2021-04-22

Systemic reaction (other): For 3 days after 2nd shot I was sick as a dog. All my symptoms made me feel like I had a virus. Was in bed for 3 days. The symptoms started almost 24 hrs. After 2nd shot.

Release 8 — day 35, dose 2

2021-05-15

Symptoms: 2 severe colitis attacks. Ive had this condition for many years. I experienced this attacks quite frequently for several years. Havent had an attack like I did in 20 yrs.

Release 8 — day 42, dose 2

2021-05-22

Symptoms: My colitis has come back with a vengeance. I had it years ago., & now its back

Healthcare visit (other): On Monday. My primary Physician, to see what can be done.

Release 9 — 3 months, dose 2

2021-07-10

Symptoms: My colitis is back with a vengeance. Havent had an attack since 2016 & now ive had 5 in the last month. Dr. Is sending me to a gastroenterologist.

Healthcare visit (other): Primary Dr.

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	Office visit	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Colitis	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Hypersomnia	✓	✓	○
SRO	Malaise	·	·	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Viral infection	✓	✓	○

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