5MH-14679-17774

4 vaccinations 13 coded responses 25 check-ins 12 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 152 / PA
Registered: 2021-02-06

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

2021-02-06
Registered in v-safe
2021-02-06
Dose 1 — Moderna
2021-02-06
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

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

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-09
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Have fibromyalgia & osteoarthritis so think this is the problem. It snowed.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — days 1–6 daily, dose 1
MedDRA: Fibromyalgia, Osteoarthritis — Feeling: Fair · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Fibromyalgia & Osteoarthritis flares due to weather.

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

Free text: Fibromyalgia & osteoarthritis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Fatigue or tiredness, Nausea

Adult check-in
2021-02-13
Health check-in — day 7, dose 1
Feeling: Fair · Joint pains

Adult check-in
2021-02-20
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-27
Survey response — day 21, dose 1
MedDRA: Headache, Muscle spasms — Feeling: Fair · Be unable to do your normal daily activities

Free text: Leg & back spasms from other health issues. Headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-11
Dose 2 — Moderna
2021-05-08
Survey response — 3 months, dose 1
MedDRA: Arthralgia, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Pain in leg & ankle

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-07
Survey response — 6 months, dose 1
MedDRA: Arthralgia, Back pain, Erythema, Hospitalisation, Peripheral swelling — Feeling: Poor · 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: Swollen calf & redness & sharp pain in ankle. No explanation per infectious disease doctor. Nothing shows in blood tests. Started 6 weeks after 2nd shot. Pain in lumbar back & joints. Hospitalized for both.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-07
Report sent to call center — 6 months, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-13
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-12-20
Dose 3 — Pfizer-BioNTech
2022-02-06
Survey response — 12 months, dose 1
MedDRA: Arthralgia, Back pain, Fatigue, Hypoaesthesia, Office visit — 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

Free text: Symptoms: Lumber back pain, joint pain, numbness in left hand. Fatigue. · Healthcare visit (other): Pain Clinic & PCP

MedDRA releases: 2024-11 · check-in free text available
2022-02-06
Report sent to call center — 12 months, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-08
Call 1 — Left Voicemail
2022-02-24
Call 2 — Could Not Reach Participant
2022-02-25
Call 3 — Left Voicemail
2022-10-18
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-10-22
Survey response — days 1–6 daily, dose 4
MedDRA: No adverse event — Feeling: Fair · Site: Redness, Swelling, Itching · Joint pains, Nausea

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-10-23
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Joint pains, Fatigue or tiredness, Nausea

Adult check-in
2022-10-24
Survey response — days 1–6 daily, dose 4
MedDRA: Pre-existing disease — Feeling: Fair · Chills, Joint pains, Fatigue or tiredness

Free text: Have osteoarthritis. Fibromyalgia.

MedDRA releases: 2024-11 · check-in free text available
2022-10-25
Health check-in — day 7, dose 4
Feeling: Fair · Chills, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-01
Survey response — day 14, dose 4
MedDRA: Discharge, Medical counselling, Office visit, Skin ulcer — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Leg ulcers & drainage · Healthcare visit (other): Dr office & home heslth nurse

MedDRA releases: 2024-11 · check-in free text available
2022-11-01
Report sent to call center — day 14, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-11-02
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-02
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-08
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-11-15
Survey response — day 28, dose 4
MedDRA: Arthralgia, Erythema, Skin ulcer — Feeling: Fair · Be unable to do your normal daily activities

Free text: Draining ulcers on ankle redness & pain.

MedDRA releases: 2024-11 · check-in free text available
2022-11-22
Survey response — day 35, dose 4
MedDRA: Burning sensation, Discharge, Erythema, Office visit, Skin ulcer — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Leg ulcers. Complete ankle redness, burning & drainage. Possible from injections of Triamcinolone Aceto. in hip joint. · Healthcare visit (other): Home healthcare nurse

MedDRA releases: 2024-11 · check-in free text available
2022-11-22
Report sent to call center — day 35, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-11-23
Call 1 — Left Voicemail
2022-11-29
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2023-01-17
Survey response — 3 months, dose 4
MedDRA: Vasculitis — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-04-18
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-06	Moderna
2	2021-03-11	Moderna	No
3	2021-12-20	Pfizer-BioNTech	No
4	2022-10-18	Pfizer-BioNTech	Flu

Call center

4 call center cases

3 successful · 1 unsuccessful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-09

Systemic reaction (other): Have fibromyalgia & osteoarthritis so think this is the problem. It snowed.

Release 4 — days 1–6 daily, dose 1

2021-02-10

Systemic reaction (other): Fibromyalgia & Osteoarthritis flares due to weather.

2021-02-11

Systemic reaction (other): Fibromyalgia & osteoarthritis

Release 4 — day 21, dose 1

2021-02-27

Symptoms: Leg & back spasms from other health issues. Headache

Release 8 — 3 months, dose 1

2021-05-08

Symptoms: Pain in leg & ankle

Release 9 — 6 months, dose 1

2021-08-07

Symptoms: Swollen calf & redness & sharp pain in ankle. No explanation per infectious disease doctor. Nothing shows in blood tests. Started 6 weeks after 2nd shot. Pain in lumbar back & joints. Hospitalized for both.

Release 11 — 12 months, dose 1

2022-02-06

Symptoms: Lumber back pain, joint pain, numbness in left hand. Fatigue.

Healthcare visit (other): Pain Clinic & PCP

Release 12 — days 1–6 daily, dose 4

2022-10-22

Systemic reaction (other): No

2022-10-24

Systemic reaction (other): Have osteoarthritis. Fibromyalgia.

Release 12 — day 14, dose 4

2022-11-01

Symptoms: Leg ulcers & drainage

Healthcare visit (other): Dr office & home heslth nurse

Release 12 — day 28, dose 4

2022-11-15

Symptoms: Draining ulcers on ankle redness & pain.

Release 12 — day 35, dose 4

2022-11-22

Symptoms: Leg ulcers. Complete ankle redness, burning & drainage. Possible from injections of Triamcinolone Aceto. in hip joint.

Healthcare visit (other): Home healthcare nurse

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	Office visit	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Back pain	✓	·	✓
SD	Burning sensation	·	·	✓
SD	Discharge	·	·	✓
SD	Erythema	✓	·	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Hospitalisation	✓	·	✓
SD	Hypoaesthesia	·	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Peripheral swelling	✓	·	✓
SD	Skin ulcer	·	·	✓
SD	Vasculitis	·	·	✓
SRO	Fibromyalgia	✓	✓	✓
SRO	No adverse event	·	·	✓
SRO	Osteoarthritis	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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