544-31895-94595

2 vaccinations 6 coded responses 22 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 837 / ID
Registered: 2021-01-18

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

2021-01-16
Dose 1 — Moderna
2021-01-18
Registered in v-safe
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-18
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Itching · Fatigue or tiredness

Adult check-in
2021-01-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-01-23
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-01-30
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-06
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-13
Dose 2 — Moderna
2021-02-13
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Had significant right lower back pain early morning felt like kidney pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Condition aggravated, Pre-existing disease, Self-medication — Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Started having lower right back pain again last night. Felt kidney pain again. I took Tylenol and went to bed and pain subsided and I fell asleep. Woke up pain free no kidney/lower right back pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-17
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain lower — Feeling: Good

Free text: Still occasionally right side lower pain like kidney pain not sure and not chronic

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Renal pain — Feeling: Good

Free text: Still random pain in lower right back like kidney, but less today and urine still looks normal

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-13
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-15
Survey response — 3 months, dose 2
MedDRA: Urinary tract infection — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Urinary tract infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Report sent to call center — 3 months, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-14
Call 1 — Left Voicemail
2021-08-14
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-13
Survey response — 12 months, dose 2
MedDRA: Gastritis, Gastrointestinal disorder, Ovarian cyst — 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 · Outpatient clinic or urgent care clinic visit

Free text: Stomach issues, not digesting good as well. Gastritis. Cyst on ovary

MedDRA releases: 2024-11 · check-in free text available
2022-02-13
Report sent to call center — 12 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-15
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-16	Moderna
2	2021-02-13	Moderna

Call center

3 call center cases

2 unsuccessful · 1 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-14

Systemic reaction (other): Had significant right lower back pain early morning felt like kidney pain

2021-02-15

Systemic reaction (other): Started having lower right back pain again last night. Felt kidney pain again. I took Tylenol and went to bed and pain subsided and I fell asleep. Woke up pain free no kidney/lower right back pain.

2021-02-17

Systemic reaction (other): Still occasionally right side lower pain like kidney pain not sure and not chronic

2021-02-18

Systemic reaction (other): Still random pain in lower right back like kidney, but less today and urine still looks normal

Release 8 — 3 months, dose 2

2021-05-15

Symptoms: Urinary tract infection

Release 11 — 12 months, dose 2

2022-02-13

Symptoms: Stomach issues, not digesting good as well. Gastritis. Cyst on ovary

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	Gastritis	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Ovarian cyst	·	·	✓
SD	Urinary tract infection	✓	✓	✓
SRO	Abdominal pain lower	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Renal pain	✓	✓	✓
SRO	Self-medication	✓	✓	✓

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