5FV-22867-09234

3 vaccinations 7 coded responses 25 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 990 / WA
Registered: 2021-01-13

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

2021-01-05
Dose 1 — Moderna
2021-01-13
Registered in v-safe
2021-01-13
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain, Swelling · Nausea

Adult check-in
2021-01-19
Survey response — day 14, dose 1
MedDRA: Abdominal pain lower, Decreased appetite, Laboratory test normal, Ultrasound abdomen normal — Feeling: Fair · Be unable to work, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Right lower quadrant pain (negative lab work and negative ultrasound); the pain will be stabbing at times; This is accompanied with loss of appetite. Symptoms started 4 days after vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Report sent to call center — day 14, dose 1
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-28
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-02
Dose 2 — Moderna
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work

Adult check-in
2021-02-05
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain, Abdominal pain lower, Malaise, Pain, Pyrexia — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Right lower quadrant pain. I had the same pain after my first shot as well; the pain was so bad I had lab work, an ultrasound and a CT all which were normal. However in the middle of the night after my second dose, I woke up in the morning with thsame horrible pain on my right lower abdomen...burning pain. My fever is gone but I would say I have generalized malaise and this horrible abdominal pain!!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal discomfort, Abdominal pain lower, Arthralgia, Groin pain — Feeling: Fair · Site: Itching · Joint pains, Fatigue or tiredness, Nausea, Abdominal pain

Free text: Continued right lower quadrant pain that is like a burning with sharp stabs that go to my right hip and groin

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: Abdominal pain — Feeling: Fair · Site: Itching · Fatigue or tiredness, Abdominal pain

Free text: Truly, the abdominal pain is the ongoing right pelvic/abdominal pain I have been reporting, sharp & stabbing at times, burning the rest of the time. I cannot attribute it to anything other than the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal discomfort, Abdominal pain — Feeling: Fair · Fatigue or tiredness, Abdominal pain

Free text: Continued right sided burning abdominal pain with intermittent stabbing pains

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — day 7, dose 2
MedDRA: Burning sensation, Pain — Feeling: Fair · Nausea, Abdominal pain · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: My main symptom lagging on is the burning in my side w/ the intermittent sharp stabbing pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Report sent to call center — day 7, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-12
Call 1 — Left Voicemail
2022-01-09
Dose 3 — Moderna
2022-01-10
Survey response — days 1–6 daily, dose 3
MedDRA: Flank pain — Feeling: Poor · Site: Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Extreme flank pain, the worst I've ever had

MedDRA releases: 2024-11 · check-in free text available
2022-01-11
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2022-01-12
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-01-13
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-01-14
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-01-15
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-01-16
Health check-in — day 7, dose 3
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2022-01-23
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-30
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-02-06
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-02-13
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-20
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-04-13
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-05	Moderna
2	2021-02-02	Moderna
3	2022-01-09	Moderna	No

Call center

3 call center cases

3 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 2 — day 14, dose 1

2021-01-19

Symptoms: Right lower quadrant pain (negative lab work and negative ultrasound); the pain will be stabbing at times; This is accompanied with loss of appetite. Symptoms started 4 days after vaccine

Release 3 — days 1–6 daily, dose 2

2021-02-05

Systemic reaction (other): Right lower quadrant pain. I had the same pain after my first shot as well; the pain was so bad I had lab work, an ultrasound and a CT all which were normal. However in the middle of the night after my second dose, I woke up in the morning with thsame horrible pain on my right lower abdomen...burning pain. My fever is gone but I would say I have generalized malaise and this horrible abdominal pain!!

2021-02-06

Systemic reaction (other): Continued right lower quadrant pain that is like a burning with sharp stabs that go to my right hip and groin

2021-02-07

Systemic reaction (other): Truly, the abdominal pain is the ongoing right pelvic/abdominal pain I have been reporting, sharp & stabbing at times, burning the rest of the time. I cannot attribute it to anything other than the vaccine

2021-02-08

Systemic reaction (other): Continued right sided burning abdominal pain with intermittent stabbing pains

Release 4 — day 7, dose 2

2021-02-10

Systemic reaction (other): My main symptom lagging on is the burning in my side w/ the intermittent sharp stabbing pain.

Release 10 — days 1–6 daily, dose 3

2022-01-10

Systemic reaction (other): Extreme flank pain, the worst I've ever had

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	Abdominal pain lower	✓	✓	✓
SD	Decreased appetite	✓	✓	✓
SD	Laboratory test normal	○	✓	○
SD	Ultrasound abdomen normal	○	✓	○
SRO	Abdominal discomfort	✓	✓	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Abdominal pain lower	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Burning sensation	✓	✓	✓
SRO	Flank pain	·	·	✓
SRO	Groin pain	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pyrexia	✓	✓	✓

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