5VU-12618-86416

3 vaccinations 10 coded responses 20 check-ins 9 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 172 / PA
Registered: 2021-04-06

Relationship: Self
Race: Multiracial
Ethnicity: N/A

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-13
Dose 1 — Moderna
2021-04-06
Registered in v-safe
2021-04-06
Survey response — day 21, dose 1
MedDRA: Mobility decreased, Musculoskeletal stiffness, Pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Right side of body from the neck down is very stiff painful can not move arm around or turn my head properly not sure if this could be one of my other medical issues.? But its only been for five days maybe six now that I have been like this.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Dose 2 — Moderna
2021-04-10
Health check-in — day 0, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-17
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-24
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-01
Survey response — day 21, dose 2
MedDRA: Migraine, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Im having migraines a lot . I m keeping track of them and everything else. For example the muscle aches and pain. Its eased up from the beginning with shots. But the migraines theyve continued on.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Survey response — day 28, dose 2
MedDRA: Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headaches more often

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Survey response — day 35, dose 2
MedDRA: Bronchitis, Candida infection, Fatigue, Rash — Feeling: Fair · Be unable to do your normal daily activities

Free text: Thrush like bumps in throat . Bronchitis again need to notify my doctor to get medicine for it. Just tiired feeling wore out

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-24
Survey response — day 42, dose 2
MedDRA: Asthenia, Pre-existing disease — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Restricted lung disease + other lung issues,stomach &boul &intestines Stage3 kidneys,spinal not repairable,lupus fiber myalgia osteoporosis Ect 17 yrs&health is declining worse in 6+yrs no strength weakIv seen 20+Drs&testing done. And no answers.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-12
Survey response — 3 months, dose 2
MedDRA: Abdominal pain upper, Muscle disorder, Pain in extremity, SARS-CoV-2 test, Vomiting — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: Muscular something is pushing out on right hip down leg dont know what happened & Im trying to see a dr . Emergency room turned me away. Yes even with my vomiting. Any suggestions Im in pain stomach &legs. But turned away. Did get c-vtest no · Healthcare visit (other): Several COVID tests no answer on last1

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-12
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

1 call case(s)
2021-07-21
Call 2 — Left Voicemail
2021-10-09
Survey response — 6 months, dose 2
MedDRA: Fluid retention, Gastric ulcer, Headache, Office visit, Peripheral swelling, Swelling — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Headaches worse than a migraine increase. Swelling all over body, legs arms hands Ect. Holding fluids in body seen Cardiologist because of concern. Stomach ulcers appeared. Seen Specialists Drs don't know what's wrong?? Pulmanary has ?s on my Lungs ?

MedDRA releases: 2024-11 · check-in free text available
2022-02-18
Dose 3 — Moderna
2022-04-10
Survey response — 12 months, dose 2
MedDRA: Abdominal pain upper, Anaemia, Bronchitis, COVID-19, Feeling of body temperature change, Headache, Hospitalisation, Internal haemorrhage, Pain, Pulmonary 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, Emergency room or emergency department visit, Hospitalization

Free text: Had COVID from 1-12 to1-29-2022 then hospital bleeding internally,sharp pains stomach,lungs,with bronchitis also w/COVID since headaches hot&cold body hurts.Had blood transfusions extremely anemic trying to get with specialist as hospital advised.

MedDRA releases: 2024-11 · check-in free text available
2022-04-10
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-04-13
Call 1 — Left Voicemail
2022-05-21
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-08-19
Survey response — 6 months, dose 3
MedDRA: Migraine, Parosmia, Taste disorder — Feeling: Poor · Be unable to do your normal daily activities

Free text: Headaches/Severe Migraines are every day no breaks from them,also my taste & smells aren not normal

MedDRA releases: 2024-11 · check-in free text available
2023-02-18
Survey response — 12 months, dose 3
MedDRA: Bronchitis, Generalised oedema, Migraine, Office visit, Pain, Rash — 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 · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-02-18
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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-02-20
Call 1 — Left Voicemail
2023-02-20
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-13	Moderna
2	2021-04-10	Moderna
3	2022-02-18	Moderna	No

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 7 — day 21, dose 1

2021-04-06

Symptoms: Right side of body from the neck down is very stiff painful can not move arm around or turn my head properly not sure if this could be one of my other medical issues.? But its only been for five days maybe six now that I have been like this.

Release 8 — day 21, dose 2

2021-05-01

Symptoms: Im having migraines a lot . I m keeping track of them and everything else. For example the muscle aches and pain. Its eased up from the beginning with shots. But the migraines theyve continued on.

Release 8 — day 28, dose 2

2021-05-09

Symptoms: Headaches more often

Release 8 — day 35, dose 2

2021-05-17

Symptoms: Thrush like bumps in throat . Bronchitis again need to notify my doctor to get medicine for it. Just tiired feeling wore out

Release 8 — day 42, dose 2

2021-05-24

Symptoms: Restricted lung disease + other lung issues,stomach &boul &intestines Stage3 kidneys,spinal not repairable,lupus fiber myalgia osteoporosis Ect 17 yrs&health is declining worse in 6+yrs no strength weakIv seen 20+Drs&testing done. And no answers.

Release 9 — 3 months, dose 2

2021-07-12

Symptoms: Muscular something is pushing out on right hip down leg dont know what happened & Im trying to see a dr . Emergency room turned me away. Yes even with my vomiting. Any suggestions Im in pain stomach &legs. But turned away. Did get c-vtest no

Healthcare visit (other): Several COVID tests no answer on last1

Release 10 — 6 months, dose 2

2021-10-09

Symptoms: Headaches worse than a migraine increase. Swelling all over body, legs arms hands Ect. Holding fluids in body seen Cardiologist because of concern. Stomach ulcers appeared. Seen Specialists Drs don't know what's wrong?? Pulmanary has ?s on my Lungs ? cut off by CDC

Release 11 — 12 months, dose 2

2022-04-10

Symptoms: Had COVID from 1-12 to1-29-2022 then hospital bleeding internally,sharp pains stomach,lungs,with bronchitis also w/COVID since headaches hot&cold body hurts.Had blood transfusions extremely anemic trying to get with specialist as hospital advised.

Release 12 — 6 months, dose 3

2022-08-19

Symptoms: Headaches/Severe Migraines are every day no breaks from them,also my taste & smells aren not normal

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	Office visit	·	·	✓
HCVO	SARS-CoV-2 test	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Anaemia	·	·	✓
SD	Asthenia	✓	✓	✓
SD	Bronchitis	✓	✓	✓
SD	Candida infection	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeling of body temperature change	·	·	✓
SD	Fluid retention	·	·	✓
SD	Gastric ulcer	·	·	✓
SD	Generalised oedema	·	·	✓
SD	Headache	✓	✓	✓
SD	Hospitalisation	·	·	✓
SD	Internal haemorrhage	·	·	✓
SD	Migraine	✓	✓	✓
SD	Mobility decreased	✓	✓	✓
SD	Muscle disorder	✓	✓	✓
SD	Musculoskeletal stiffness	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Office visit	·	·	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Parosmia	·	·	✓
SD	Peripheral swelling	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pulmonary pain	·	·	✓
SD	Rash	✓	✓	✓
SD	SARS-CoV-2 test	✓	✓	✓
SD	Swelling	·	·	✓
SD	Taste disorder	·	·	✓
SD	Vomiting	✓	✓	✓

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