57N-46821-56374

2 vaccinations 8 coded responses 27 check-ins 8 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 920 / CA
Registered: 2021-02-05

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

2021-02-05
Registered in v-safe
2021-02-05
Dose 1 — Moderna
2021-02-05
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-08
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Headache, Immediate post-injection reaction, Swelling — Feeling: Fair · Headache, Joint pains

Free text: Didnt connect at first but day of injection the right side of the back of my neck felt slightly swollen right after the injection and then headache for 2 days. Today headache gone but right sholder is sore but not injction site.

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

Adult check-in
2021-02-10
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Arthritis, Myalgia, Pre-existing disease — Feeling: Good · Joint pains, Muscle or body aches

Free text: Leg muscles ache and knee arthritis more painful. Can't say if related to vaccine or activities.

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

Adult check-in
2021-02-12
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Survey response — day 14, dose 1
MedDRA: Abscess rupture, Diverticulitis, Hospitalisation, Platelet count decreased — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Had a bad diverticulitis infection with ruptured absess in bowel. 4 days in hospital. Platlet count dropped from 130 to 98

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Report sent to call center — day 14, dose 1
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)
2021-02-26
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-03-12
Health check-in — day 35, dose 1
Feeling: Fair

Adult check-in
2021-03-13
Dose 2 — Moderna
2021-03-13
Survey response — day 0, dose 2
MedDRA: Ligament sprain, Pain — Feeling: Good

Free text: Just a sprained knee before vaccine. Not sure what to take for the pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · None

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-20
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-04
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-11
Survey response — day 28, dose 2
MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Knee pain and shoulder pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-26
Survey response — day 42, dose 2
MedDRA: Headache, Urinary tract infection — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Still having recurring headaches and uti infection as well as my husband and 8 other of my friends who all got the second shot at the same time.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-14
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Diverticulitis, Pain in extremity, Tendon pain — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Diverticulitis and sore knees and tendons. Sore right arm where injections wrre administered

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-14
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-06-17
Call 1 — Left Voicemail
2021-09-11
Survey response — 6 months, dose 2
MedDRA: Arthropathy, Back pain, Diverticulitis, Headache, Office visit, Physiotherapy — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Symptoms: Knee problem and still having headaches from the vaccine. Also constant back pain. Not sure why. Getting pt for my knee&back. · Healthcare visit (other): In person visit. Awaiting surgery for diverticulitis also.

MedDRA releases: 2024-11 · check-in free text available
2021-09-11
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-15
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-05	Moderna
2	2021-03-13	Moderna

Call center

4 call center cases

4 unsuccessful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-08

Systemic reaction (other): Didnt connect at first but day of injection the right side of the back of my neck felt slightly swollen right after the injection and then headache for 2 days. Today headache gone but right sholder is sore but not injction site.

Release 4 — days 1–6 daily, dose 1

2021-02-10

Systemic reaction (other): Leg muscles ache and knee arthritis more painful. Can't say if related to vaccine or activities.

Release 4 — day 14, dose 1

2021-02-19

Symptoms: Had a bad diverticulitis infection with ruptured absess in bowel. 4 days in hospital. Platlet count dropped from 130 to 98

Release 5 — day 0, dose 2

2021-03-13

Systemic reaction (other): Just a sprained knee before vaccine. Not sure what to take for the pain

Release 7 — day 28, dose 2

2021-04-11

Symptoms: Knee pain and shoulder pain

Release 8 — day 42, dose 2

2021-04-26

Symptoms: Still having recurring headaches and uti infection as well as my husband and 8 other of my friends who all got the second shot at the same time.

Release 9 — 3 months, dose 2

2021-06-14

Symptoms: Diverticulitis and sore knees and tendons. Sore right arm where injections wrre administered

Release 9 — 6 months, dose 2

2021-09-11

Symptoms: Knee problem and still having headaches from the vaccine. Also constant back pain. Not sure why. Getting pt for my knee&back.

Healthcare visit (other): In person visit. Awaiting surgery for diverticulitis also.

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	Diverticulitis	·	·	✓
HCVO	Office visit	·	·	✓
SD	Abscess rupture	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Arthropathy	·	·	✓
SD	Back pain	·	·	✓
SD	Diverticulitis	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hospitalisation	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Physiotherapy	·	·	✓
SD	Platelet count decreased	✓	✓	✓
SD	Tendon pain	✓	✓	✓
SD	Urinary tract infection	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Arthritis	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Ligament sprain	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Swelling	✓	✓	✓

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