4LG-33418-03707
4 vaccinations
4 coded responses
18 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 221 / VA
- Registered
- 2021-02-11
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-11
Registered in v-safe
-
2021-02-11
Dose 1 — Moderna
-
2021-02-16
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-17
-
2021-02-18
Survey response — day 7, dose 1MedDRA: Pain, Pre-existing disease, Sensitivity to weather change — Feeling: Good · Joint pains · Be unable to do your normal daily activitiesFree text: I have Arthritis all over my body my pain is probably come from it, plus damp weatherMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-25
-
2021-03-04
Survey response — day 21, dose 1MedDRA: Arthralgia, Pain in extremity, Pre-existing disease, X-ray — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: I am having severe aching in my hips and down my left leg to my ankle. My primary care Dr. Sent me for X-Rays today. I have always had Spine & Disc problem. She thinks it Sciata Nerves.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-04
Report sent to call center — day 21, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-12
Dose 2 — Moderna
- 2021-05-13
- 2021-08-12
- 2021-09-10
-
2022-01-23
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-03-12
-
2022-04-13
Dose 3 — Moderna
-
2022-04-29
Survey response — day 14, dose 3MedDRA: Back disorder, Fall, Gait disturbance, Neck pain, Physiotherapy, Posture abnormal, Thoracic vertebral fracture, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, HospitalizationFree text: Symptoms: Due to a fall I fractured the T1 vertebrae, I messed up my upper back&neck. PT released me Wed. But I am still walking with my head drooped, which causes neck pain. · Healthcare visit (other): PTMedDRA releases: 2024-11 · check-in free text available
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2022-04-29
Report sent to call center — day 14, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Hospitalization · 1 call case(s)
-
2022-05-02
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-05-04
- 2022-05-11
-
2022-05-15
Dose 4 — Moderna
- 2022-05-18
- 2022-05-25
- 2022-07-13
- 2022-08-14
- 2022-11-13
- 2023-05-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-11 | Moderna | |
| 2 | 2021-03-12 | Moderna | No |
| 3 | 2022-04-13 | Moderna | No |
| 4 | 2022-05-15 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): No
Release 4 — day 7, dose 1
Systemic reaction (other): I have Arthritis all over my body my pain is probably come from it, plus damp weather
Release 5 — day 21, dose 1
Symptoms: I am having severe aching in my hips and down my left leg to my ankle. My primary care Dr. Sent me for X-Rays today. I have always had Spine & Disc problem. She thinks it Sciata Nerves.
Release 11 — day 14, dose 3
Symptoms: Due to a fall I fractured the T1 vertebrae, I messed up my upper back&neck. PT released me Wed. But I am still walking with my head drooped, which causes neck pain.
Healthcare visit (other): PT
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 | Physiotherapy | · | · | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Back disorder | · | · | ✓ |
| SD | Fall | · | · | ✓ |
| SD | Gait disturbance | · | · | ✓ |
| SD | Neck pain | · | · | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Physiotherapy | · | · | ✓ |
| SD | Posture abnormal | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Thoracic vertebral fracture | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SD | X-ray | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Sensitivity to weather change | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release