4WD-23921-96242

2 vaccinations 9 coded responses 20 check-ins 9 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 996 / AK
Registered: 2021-02-11

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-02-10
Dose 1 — Moderna
2021-02-11
Registered in v-safe
2021-02-11
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Back pain — Feeling: Fair · Site: Pain, Redness · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Low back and right hip pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness, Swelling · Joint pains, Diarrhea, Abdominal pain

Adult check-in
2021-02-14
Survey response — days 1–6 daily, dose 1
MedDRA: Musculoskeletal stiffness — Feeling: Good · Site: Itching · Muscle or body aches

Free text: Stiffness and it takes a moment to stand up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-16
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good · Joint pains

Free text: Not sure if its related to the shot or my medication.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — day 7, dose 1
MedDRA: Gingival bleeding, Toothache — Feeling: Good · Site: Itching

Free text: Toothache and bleeding gums. Have not had these symptoms before the shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Survey response — day 14, dose 1
MedDRA: Injection site reaction — Feeling: Good

Free text: Shot site flared up. Got warm and red for a few days. It is fine now. I had a root canal for an abscess so was taking antibiotics. Not sure if it is related to the infection or not though.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-10
Dose 2 — Moderna
2021-03-11
Survey response — days 1–6 daily, dose 2
MedDRA: Pain — Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain

Free text: I have a high tolerance for pain so what I rate as mild others would rate higher.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Rash papular — Feeling: Fair · Site: Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: Raised red area is 4-5 " across now. Initially it was 3 " across on Thursday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-17
Health check-in — day 7, dose 2
Feeling: Good · Site: Swelling, Itching · Joint pains, Muscle or body aches

Adult check-in
2021-03-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-31
Survey response — day 21, dose 2
MedDRA: Abdominal distension, Diarrhoea, Dyspnoea, Faeces soft, Flatulence, Gastrointestinal disorder, Gastrointestinal sounds abnormal, Pain — Feeling: Fair

Free text: Gastrointestinal problems, soft and loose stools for the last week or so. Bloating, gas and gurgling of the belly/intestinal area. Shortness of breath when walking short distances. Experienced sharp pain in my upper left quadrant also.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-15
Survey response — day 35, dose 2
MedDRA: Asthenia, Fatigue, Lethargy, Tremor — Feeling: Fair

Free text: Lethargy, tiredness and some weakness. Shaking, but that could be related to a medication.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-09-15
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-03-12
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-10	Moderna
2	2021-03-10	Moderna

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-11

Systemic reaction (other): Low back and right hip pain.

2021-02-14

Systemic reaction (other): Stiffness and it takes a moment to stand up

2021-02-16

Systemic reaction (other): Not sure if its related to the shot or my medication.

Release 4 — day 7, dose 1

2021-02-17

Systemic reaction (other): Toothache and bleeding gums. Have not had these symptoms before the shot.

Release 4 — day 14, dose 1

2021-02-26

Symptoms: Shot site flared up. Got warm and red for a few days. It is fine now. I had a root canal for an abscess so was taking antibiotics. Not sure if it is related to the infection or not though.

Release 5 — days 1–6 daily, dose 2

2021-03-11

Systemic reaction (other): I have a high tolerance for pain so what I rate as mild others would rate higher.

2021-03-13

Systemic reaction (other): Raised red area is 4-5 " across now. Initially it was 3 " across on Thursday.

Release 6 — day 21, dose 2

2021-03-31

Symptoms: Gastrointestinal problems, soft and loose stools for the last week or so. Bloating, gas and gurgling of the belly/intestinal area. Shortness of breath when walking short distances. Experienced sharp pain in my upper left quadrant also.

Release 7 — day 35, dose 2

2021-04-15

Symptoms: Lethargy, tiredness and some weakness. Shaking, but that could be related to a medication.

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
SD	Abdominal distension	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Faeces soft	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Flatulence	✓	✓	✓
SD	Gastrointestinal disorder	✓	✓	✓
SD	Gastrointestinal sounds abnormal	✓	✓	✓
SD	Injection site reaction	✓	✓	✓
SD	Lethargy	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Tremor	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Gingival bleeding	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Rash papular	✓	✓	✓
SRO	Toothache	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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