5YV-31313-65777

2 vaccinations 6 coded responses 23 check-ins 6 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 330 / FL
Registered: 2021-01-06

Relationship: Self
Race: White
Ethnicity: N/A

Timeline

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

2021-01-06
Registered in v-safe
2021-01-06
Dose 1 — Moderna
2021-01-06
Survey response — day 0, dose 1
MedDRA: No adverse event — Feeling: Good · Site: Swelling · Joint pains, Nausea

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

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

Adult check-in
2021-01-21
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-27
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-03
Dose 2 — Moderna
2021-02-03
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Eye pain, Lacrimation increased, Ocular hyperaemia, Retinal haemorrhage — Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Pain in right eye that has had a macular bleed today a little better but having pain in left ear and cheek area tender to touch and left eye is red and tearing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-18
Survey response — day 14, dose 2
MedDRA: Eye swelling, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Right eye swollen · Healthcare visit (other): See optamoligist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-03
Survey response — day 28, dose 2
MedDRA: Arthralgia, Headache, Induration, Myalgia, Neck pain, Nodule, Physiotherapy — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Extreme muscle aches and pain in shoulders, neck and base of skull.Went to therapy and had a massage and used tens machine to help. Had hard knots all thru the area. Doing better now · Healthcare visit (other): Physical therapy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-03
Call 1 — Left Voicemail
2021-08-04
Survey response — 6 months, dose 2
MedDRA: Back pain, Neck pain, Office visit, Uveitis — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Severe neck pain and back pain. I also had uveitis of right eye from February till about a week ago. Severe reaction right after second shot . · Healthcare visit (other): Went to my Rheumatologist

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-04
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-24
Call 1 — Left Voicemail
2022-02-03
Survey response — 12 months, dose 2
MedDRA: Office visit, Pancreatitis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Problems with pancreatitis · Healthcare visit (other): Doctor appointment

MedDRA releases: 2024-11 · check-in free text available
2022-02-03
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

1 call case(s)
2022-02-04
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-06	Moderna
2	2021-02-03	Moderna

Call center

4 call center cases

4 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 1 — day 0, dose 1

2021-01-06

Systemic reaction (other): No

Release 3 — days 1–6 daily, dose 2

2021-02-04

Systemic reaction (other): Pain in right eye that has had a macular bleed today a little better but having pain in left ear and cheek area tender to touch and left eye is red and tearing

Release 4 — day 14, dose 2

2021-02-18

Symptoms: Right eye swollen

Healthcare visit (other): See optamoligist

Release 5 — day 28, dose 2

2021-03-03

Symptoms: Extreme muscle aches and pain in shoulders, neck and base of skull.Went to therapy and had a massage and used tens machine to help. Had hard knots all thru the area. Doing better now

Healthcare visit (other): Physical therapy

Release 9 — 6 months, dose 2

2021-08-04

Symptoms: Severe neck pain and back pain. I also had uveitis of right eye from February till about a week ago. Severe reaction right after second shot .

Healthcare visit (other): Went to my Rheumatologist

Release 11 — 12 months, dose 2

2022-02-03

Symptoms: Problems with pancreatitis

Healthcare visit (other): Doctor appointment

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	Physiotherapy	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Back pain	✓	·	✓
SD	Eye swelling	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Induration	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Nodule	✓	✓	✓
SD	Pancreatitis	·	·	✓
SD	Uveitis	✓	·	✓
SRO	Eye pain	✓	✓	✓
SRO	Lacrimation increased	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Ocular hyperaemia	✓	✓	✓
SRO	Retinal haemorrhage	✓	✓	✓

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