55M-31313-65506

2 vaccinations 10 coded responses 24 check-ins 10 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 100 / NY
Registered: 2021-02-14

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-02-14
Registered in v-safe
2021-02-14
Dose 1 — Moderna
2021-02-14
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain, Swelling · Headache

Adult check-in
2021-02-15
Survey response — days 1–6 daily, dose 1
MedDRA: Pain, Pain in extremity — Feeling: Good · Site: Pain, Swelling · Headache, Muscle or body aches

Free text: Left arm sore,hurts a little when I lift my arm

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

Adult check-in
2021-02-17
Survey response — days 1–6 daily, dose 1
MedDRA: Headache, Injection site pain — Feeling: Good · Site: Pain · Headache

Free text: A tiny bit of pain around injection site, slight headache tdy & yesterday evening

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-21
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · Headache

Adult check-in
2021-02-28
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-07
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-14
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-15
Dose 2 — Moderna
2021-03-16
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Sluggishness — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Sluggish, lower backache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — days 1–6 daily, dose 2
MedDRA: Balance disorder, Sluggishness — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Slightly sluggish, a little off balance

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Fatigue or tiredness

Free text: Some lower backache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Fatigue or tiredness, Nausea

Free text: Slight lower backache,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain, Back pain, Nasal congestion, Sneezing — Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness

Free text: Slight pain under upper arm pit Lots sneezing, stuffy nose, slight lower backache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Headache, Nausea

Adult check-in
2021-03-22
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · Headache

Adult check-in
2021-03-30
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-05
Survey response — day 21, dose 2
MedDRA: Tension headache — Feeling: Fair

Free text: Having mini Tension Headaches, 2-3x a wk in the last 3 weeks, woke up with some, some occurred in the middle of the day. Dont know what triggered them.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — day 28, dose 2
MedDRA: Tension headache — Feeling: Fair

Free text: Mini Tension Headaches a little more frequent, 2x a week, sometimes 3x a week

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Survey response — day 35, dose 2
MedDRA: Tension headache — Feeling: Good

Free text: Its not really worse, but still getting the mini Tension Headaches 2-3x a week, sometimes 2 in one day. They come on all of a sudden & last for 5-10 mins, stop & then come back later in the day or at night. Wake up with them also. O.k otherwise so fa

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-14
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-16
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-14	Moderna
2	2021-03-15	Moderna

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-15

Systemic reaction (other): Left arm sore,hurts a little when I lift my arm

2021-02-17

Systemic reaction (other): A tiny bit of pain around injection site, slight headache tdy & yesterday evening

Release 5 — days 1–6 daily, dose 2

2021-03-16

Systemic reaction (other): Sluggish, lower backache

2021-03-17

Systemic reaction (other): Slightly sluggish, a little off balance

2021-03-18

Systemic reaction (other): Some lower backache

2021-03-19

Systemic reaction (other): Slight lower backache,

Release 6 — days 1–6 daily, dose 2

2021-03-20

Systemic reaction (other): Slight pain under upper arm pit Lots sneezing, stuffy nose, slight lower backache

Release 6 — day 21, dose 2

2021-04-05

Symptoms: Having mini Tension Headaches, 2-3x a wk in the last 3 weeks, woke up with some, some occurred in the middle of the day. Dont know what triggered them.

Release 7 — day 28, dose 2

2021-04-12

Symptoms: Mini Tension Headaches a little more frequent, 2x a week, sometimes 3x a week

Release 7 — day 35, dose 2

2021-04-19

Symptoms: Its not really worse, but still getting the mini Tension Headaches 2-3x a week, sometimes 2 in one day. They come on all of a sudden & last for 5-10 mins, stop & then come back later in the day or at night. Wake up with them also. O.k otherwise so fa cut off by CDC

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	Tension headache	✓	✓	✓
SRO	Axillary pain	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Balance disorder	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Sluggishness	✓	✓	✓
SRO	Sneezing	✓	✓	✓

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