59P-11346-45999

3 vaccinations 8 coded responses 30 check-ins 8 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 800 / CO
Registered: 2020-12-29

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

2020-12-29
Registered in v-safe
2020-12-29
Dose 1 — Moderna
2020-12-29
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2020-12-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-31
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Pain

Free text: Pain injection site only

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-01
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Arthritis, Myalgia — Feeling: Good · Joint pains, Muscle or body aches

Free text: I have joint muscle pain from arthritis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-05
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-26
Dose 2 — Moderna
2021-01-26
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-01-27
Survey response — days 1–6 daily, dose 2
MedDRA: Self-medication — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Took motrin to prevent symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

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

Adult check-in
2021-02-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-07-27
Survey response — 6 months, dose 2
MedDRA: Condition aggravated, Fatigue, Pre-existing disease, Weight decreased — Feeling: Poor · Be unable to do your normal daily activities

Free text: Fatigue, tired all the time,worse muscle and joint pain. I have lost weight almostc 15 lbs. Im thinking of getting retested for covid.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-18
Dose 3 — Moderna
2021-10-23
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-01
Survey response — day 42, dose 3
MedDRA: Loss of personal independence in daily activities, Pain, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Worse pain.hard to d d0 regular household work · Healthcare visit (other): Csplllli

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Report sent to call center — day 42, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-03
Call 1 — Left Voicemail
2021-12-18
Survey response — 3 months, dose 3
MedDRA: Depression, Fatigue, Myalgia, Pain — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Fatigue, depression,muscles aches and pain

MedDRA releases: 2024-11 · check-in free text available
2021-12-18
Report sent to call center — 3 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-20
Call 1 — Left Voicemail
2022-03-21
Survey response — 6 months, dose 3
MedDRA: Depression, Insomnia, Medical counselling, Office visit, Pain — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: Body aches and pain , insomnia ,depression. My dr gave me am adfitipnal anti depressant to take · Healthcare visit (other): Phone Visit with my primary phyxiciznrymary

MedDRA releases: 2024-11 · check-in free text available
2022-03-21
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-03-22
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-09-18
Survey response — 12 months, dose 3
MedDRA: Dementia — Feeling: Fair · 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, Emergency room or emergency department visit

Free text: Dementia

MedDRA releases: 2024-11 · check-in free text available
2022-09-18
Report sent to call center — 12 months, dose 3
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 · Emergency room or emergency department visit · 1 call case(s)
2022-09-19
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-29	Moderna
2	2021-01-26	Moderna
3	2021-09-18	Moderna	No

Call center

4 call center cases

3 successful · 1 unsuccessful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-31

Systemic reaction (other): Pain injection site only

2021-01-01

Systemic reaction (other): I have joint muscle pain from arthritis

Release 2 — days 1–6 daily, dose 2

2021-01-27

Systemic reaction (other): Took motrin to prevent symptoms

Release 9 — 6 months, dose 2

2021-07-27

Symptoms: Fatigue, tired all the time,worse muscle and joint pain. I have lost weight almostc 15 lbs. Im thinking of getting retested for covid.

Release 10 — day 42, dose 3

2021-11-01

Symptoms: Worse pain.hard to d d0 regular household work

Healthcare visit (other): Csplllli

Release 10 — 3 months, dose 3

2021-12-18

Symptoms: Fatigue, depression,muscles aches and pain

Release 11 — 6 months, dose 3

2022-03-21

Symptoms: Body aches and pain , insomnia ,depression. My dr gave me am adfitipnal anti depressant to take

Healthcare visit (other): Phone Visit with my primary phyxiciznrymary

Release 12 — 12 months, dose 3

2022-09-18

Symptoms: Dementia

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	Medical counselling	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Condition aggravated	✓	·	✓
SD	Dementia	·	·	✓
SD	Depression	·	·	✓
SD	Fatigue	✓	·	✓
SD	Insomnia	·	·	✓
SD	Loss of personal independence in daily activities	·	·	✓
SD	Myalgia	·	·	✓
SD	Office visit	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Weight decreased	✓	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Arthritis	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Pre-existing disease	○	○	○
SRO	Self-medication	✓	✓	✓

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