526-17793-23277

4 vaccinations 14 coded responses 45 check-ins 14 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 871 / NM
Registered: 2021-01-21

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

2021-01-20
Dose 1 — Moderna
2021-01-21
Registered in v-safe
2021-01-22
Survey response — days 1–6 daily, dose 1
MedDRA: Office visit, Tooth infection — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness, Nausea

Free text: Been to dentist with infected toothj

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: Facial pain, Tooth infection — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Pain in face. Infected tooth

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Survey response — days 1–6 daily, dose 1
MedDRA: Tooth infection — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: Infected tooth. On antibotics day 2

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Survey response — days 1–6 daily, dose 1
MedDRA: Tooth abscess — Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Tooth abcess

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Survey response — days 1–6 daily, dose 1
MedDRA: Tooth abscess — Feeling: Good · Headache, Fatigue or tiredness

Free text: Tooth abcess

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Survey response — day 7, dose 1
MedDRA: Tooth abscess — Feeling: Good · Headache

Free text: Abcessed tooth

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — day 14, dose 1
MedDRA: Injection site rash — Feeling: Good

Free text: Developed red round nonraised rash at injection site on days 7 and 8 about 2 inches in diameter had a slight itch resolved on its own on day 9

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-17
Dose 2 — Moderna
2021-02-17
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Redness · None

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Headache

Adult check-in
2021-02-22
Survey response — days 1–6 daily, dose 2
MedDRA: Seasonal allergy — Feeling: Good · Site: Pain, Redness · Headache, Fatigue or tiredness

Free text: Having hayfever type allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-02-24
Survey response — day 7, dose 2
MedDRA: Adverse reaction — Feeling: Good · Headache

Free text: Could be from hayfever

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-17
Survey response — day 28, dose 2
MedDRA: Hordeolum, Hypersensitivity, Seasonal allergy — Feeling: Good

Free text: Stye in left eye. Continue with allergies (hayfever)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-19
Survey response — 3 months, dose 2
MedDRA: Pre-existing disease, Rash, Spinal fracture — Feeling: Good · Be unable to do your normal daily activities

Free text: Fractures in spine from osteoporsis and increasing rash mostly on back from Prolia They think)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-18
Survey response — 6 months, dose 2
MedDRA: Blood parathyroid hormone increased, Dislocation of vertebra, Office visit, Pre-existing disease, Renal failure, Thoracic vertebral fracture — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: 3 vertebal fxs of t spine. 1 subluxation L spine due to osteoporosis which is due to increase in parathyroid hormone whichis due to renal failurev · Healthcare visit (other): Renal md

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-18
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-25
Call 1 — Left Voicemail
2021-10-25
Dose 3 — Pfizer-BioNTech
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Fair · Site: Redness · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-15
Survey response — day 21, dose 3
MedDRA: Muscle spasms, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Muscle spasms with pain both legsm

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-29
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-24
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-04-09
Dose 4 — Pfizer-BioNTech
2022-04-16
Health check-in — day 7, dose 4
Feeling: Good · Site: Redness · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-23
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-30
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-07
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-14
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-21
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-09
Survey response — 3 months, dose 4
MedDRA: Office visit, Pruritus — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional

Free text: Symptoms: Total body itching. Prescribed steroids 3 d ago9 · Healthcare visit (other): Primary care

MedDRA releases: 2024-11 · check-in free text available
2022-07-09
Report sent to call center — 3 months, dose 4
Be unable to work or attend school · Get care from a doctor or other healthcare professional

1 call case(s)
2022-07-11
Call successful
Not applicable - Accidental Reporting
2022-10-11
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-10
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-20	Moderna
2	2021-02-17	Moderna
3	2021-10-25	Pfizer-BioNTech	No
4	2022-04-09	Pfizer-BioNTech	No

Call center

2 call center cases

1 successful · 1 unsuccessful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-22

Systemic reaction (other): Been to dentist with infected toothj

2021-01-23

Systemic reaction (other): Pain in face. Infected tooth

2021-01-24

Systemic reaction (other): Infected tooth. On antibotics day 2

2021-01-25

Systemic reaction (other): Tooth abcess

2021-01-26

Systemic reaction (other): Tooth abcess

Release 2 — day 7, dose 1

2021-01-27

Systemic reaction (other): Abcessed tooth

Release 3 — day 14, dose 1

2021-02-03

Symptoms: Developed red round nonraised rash at injection site on days 7 and 8 about 2 inches in diameter had a slight itch resolved on its own on day 9

Release 4 — days 1–6 daily, dose 2

2021-02-22

Systemic reaction (other): Having hayfever type allergies

Release 4 — day 7, dose 2

2021-02-24

Systemic reaction (other): Could be from hayfever

Release 5 — day 28, dose 2

2021-03-17

Symptoms: Stye in left eye. Continue with allergies (hayfever)

Release 8 — 3 months, dose 2

2021-05-19

Symptoms: Fractures in spine from osteoporsis and increasing rash mostly on back from Prolia They think)

Release 9 — 6 months, dose 2

2021-08-18

Symptoms: 3 vertebal fxs of t spine. 1 subluxation L spine due to osteoporosis which is due to increase in parathyroid hormone whichis due to renal failurev

Healthcare visit (other): Renal md

Release 10 — day 21, dose 3

2021-11-15

Symptoms: Muscle spasms with pain both legsm

Release 12 — 3 months, dose 4

2022-07-09

Symptoms: Total body itching. Prescribed steroids 3 d ago9

Healthcare visit (other): Primary care

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	Blood parathyroid hormone increased	✓	·	✓
SD	Dislocation of vertebra	✓	·	✓
SD	Hordeolum	✓	✓	✓
SD	Hypersensitivity	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Muscle spasms	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pruritus	·	·	✓
SD	Rash	✓	✓	✓
SD	Renal failure	✓	·	✓
SD	Seasonal allergy	✓	✓	✓
SD	Spinal fracture	✓	✓	✓
SD	Thoracic vertebral fracture	✓	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Facial pain	✓	✓	✓
SRO	Office visit	✓	✓	✓
SRO	Seasonal allergy	✓	✓	✓
SRO	Tooth abscess	✓	✓	✓
SRO	Tooth infection	✓	✓	✓

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