4UB-33882-03372

2 vaccinations 8 coded responses 16 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 945 / CA
Registered: 2021-04-26

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-29
Dose 1 — Moderna
2021-04-26
Registered in v-safe
2021-04-26
Dose 2 — Moderna
2021-04-26
Survey response — day 0, dose 2
MedDRA: Neck pain — Feeling: Good · Site: Pain, Swelling · Headache, Muscle or body aches

Free text: Neck ache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Influenza like illness — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: At night the symptoms were worse than today and flu-like

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Chills — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Lower back pain on both sides - may be related to kidneys? My temperature and chills were much milder today than yesterday, and most of the symptoms occur in the evening

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — days 1–6 daily, dose 2
MedDRA: Hyperhidrosis — Feeling: Good · Site: Swelling · Fatigue or tiredness

Free text: Sweating more than usual earlier in the day, but feeling more normal now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-01
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Good · Headache

Free text: Moderate headache last night - gone by morning

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-03
Survey response — day 7, dose 2
MedDRA: Headache — Feeling: Good · Headache

Free text: I had a headache most of last night

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-31
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-07
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-28
Survey response — 3 months, dose 2
MedDRA: Chills, Fatigue, Headache, Pain, Pyrexia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: High Fever, chills, headache, fatigue, bodyaches

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-25
Survey response — 6 months, dose 2
MedDRA: Muscle abscess, Pre-existing disease, Sepsis, Staphylococcal infection — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Symptoms: I came down with sepsis caused by a staff infection, but I do not think it is related to the vaccine. However, I am immune compromised because of rheumatoid arthritis. · Healthcare visit (other): Sepsis and muscle abscess

MedDRA releases: 2024-11 · check-in free text available
2021-10-25
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Hospitalization · 1 call case(s)
2021-10-26
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-26
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-29	Moderna
2	2021-04-26	Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 8 — day 0, dose 2

2021-04-26

Systemic reaction (other): Neck ache

Release 8 — days 1–6 daily, dose 2

2021-04-27

Systemic reaction (other): At night the symptoms were worse than today and flu-like

2021-04-28

Systemic reaction (other): Lower back pain on both sides - may be related to kidneys? My temperature and chills were much milder today than yesterday, and most of the symptoms occur in the evening

2021-04-29

Systemic reaction (other): Sweating more than usual earlier in the day, but feeling more normal now.

2021-05-01

Systemic reaction (other): Moderate headache last night - gone by morning

Release 8 — day 7, dose 2

2021-05-03

Systemic reaction (other): I had a headache most of last night

Release 9 — 3 months, dose 2

2021-07-28

Symptoms: High Fever, chills, headache, fatigue, bodyaches

Release 10 — 6 months, dose 2

2021-10-25

Symptoms: I came down with sepsis caused by a staff infection, but I do not think it is related to the vaccine. However, I am immune compromised because of rheumatoid arthritis.

Healthcare visit (other): Sepsis and muscle abscess

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	Muscle abscess	·	·	✓
HCVO	Sepsis	·	·	✓
SD	Chills	✓	·	✓
SD	Fatigue	✓	·	✓
SD	Headache	✓	·	✓
SD	Pain	✓	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	✓	·	✓
SD	Sepsis	·	·	✓
SD	Staphylococcal infection	·	·	✓
SRO	Back pain	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Influenza like illness	✓	✓	✓
SRO	Neck pain	✓	✓	✓

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