5AZ-31745-12139

2 vaccinations 8 coded responses 20 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 834 / ID
Registered: 2021-01-09

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

2021-01-08
Dose 1 — Moderna
2021-01-09
Registered in v-safe
2021-01-09
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain, Inflammation, Pre-existing disease — Feeling: Good · Site: Pain · Joint pains

Free text: My back chronic low back pain is worse today. I can tell I've got an inflammatory reaction going on.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness · None

Adult check-in
2021-01-15
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-29
Survey response — day 21, dose 1
MedDRA: Headache — Feeling: Good

Free text: Headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Dose 2 — Moderna
2021-02-04
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-05
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Only took my temp once when filling this out

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Loss of appetite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain, Muscle spasms — Feeling: Good · Site: Pain, Swelling · Muscle or body aches

Free text: I've had an earache and "charlie horse" on the right side of my neck since yesterday morning

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Survey response — days 1–6 daily, dose 2
MedDRA: Musculoskeletal stiffness — Feeling: Good · Site: Pain, Redness, Itching · Headache, Fatigue or tiredness

Free text: Still have a stiff neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-11
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-09
Survey response — 3 months, dose 2
MedDRA: Decreased appetite, Dysgeusia, Oral surgery — Feeling: Good

Free text: After my second shot, I did experience a loss of appetite for about 2 weeks. My sense of taste was affected, everything tasted bad beginning the day after the shot. I had oral surgery 1 wk after my shot, was on antibiotics. Not sure I reported?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-05
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-04
Survey response — 12 months, dose 2
MedDRA: Respiratory disorder, SARS-CoV-2 test negative — 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: End of Jan 2022 i had an upper respiratory illness and tested neg to covid. It lasted 2 weeks

MedDRA releases: 2024-11 · check-in free text available
2022-02-04
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)
2022-02-09
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-08	Moderna
2	2021-02-04	Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-09

Systemic reaction (other): My back chronic low back pain is worse today. I can tell I've got an inflammatory reaction going on.

Release 3 — day 21, dose 1

2021-01-29

Symptoms: Headache

Release 3 — days 1–6 daily, dose 2

2021-02-05

Systemic reaction (other): Only took my temp once when filling this out

2021-02-06

Systemic reaction (other): Loss of appetite

2021-02-07

Systemic reaction (other): I've had an earache and "charlie horse" on the right side of my neck since yesterday morning

2021-02-09

Systemic reaction (other): Still have a stiff neck

Release 8 — 3 months, dose 2

2021-05-09

Symptoms: After my second shot, I did experience a loss of appetite for about 2 weeks. My sense of taste was affected, everything tasted bad beginning the day after the shot. I had oral surgery 1 wk after my shot, was on antibiotics. Not sure I reported?

Release 11 — 12 months, dose 2

2022-02-04

Symptoms: End of Jan 2022 i had an upper respiratory illness and tested neg to covid. It lasted 2 weeks

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	Decreased appetite	✓	✓	✓
SD	Dysgeusia	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Oral surgery	✓	✓	✓
SD	Respiratory disorder	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Back pain	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Inflammation	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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