64N-31019-87706

4 vaccinations 14 coded responses 32 check-ins 13 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 928 / CA
Registered: 2020-12-30

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

2020-12-30
Registered in v-safe
2020-12-30
Dose 1 — Moderna
2020-12-30
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2020-12-31
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Headache, Neck pain, Pain, Self-medication — Feeling: Good · Site: Pain · Headache, Joint pains, Fatigue or tiredness

Free text: Headache was limited to the left side of my head. Injection was on left arm. Also a achy feeling in left shoulder and left side of neck. Subsided with Tylenol.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Chills, Fatigue or tiredness

Adult check-in
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-04
Survey response — days 1–6 daily, dose 1
MedDRA: Paranasal sinus hypersecretion — Feeling: Good · Headache, Joint pains, Fatigue or tiredness

Free text: Sinus drainage increase this past week .. maybe some sinusitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-05
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia — Feeling: Fair · Headache, Joint pains, Fatigue or tiredness

Free text: Joint pain in hands, wrists, shoulder & knees

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-06
Health check-in — day 7, dose 1
Feeling: Good · Headache, Joint pains

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

Adult check-in
2021-01-20
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-29
Dose 2 — Moderna
2021-01-29
Survey response — day 0, dose 2
MedDRA: Head discomfort, Nasal congestion, Night sweats — Feeling: Fair · Headache, Joint pains, Fatigue or tiredness

Free text: Night sweats, stuffy head/nose Joint pain more noticeable in a.m.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-01
Survey response — days 1–6 daily, dose 2
MedDRA: Balance disorder — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Seem to be a bit unsteady. Not really dizzy, but unbalanced feeling.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Survey response — days 1–6 daily, dose 2
MedDRA: Disturbance in attention — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Have trouble focusing mind when on task.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Self-medication — Feeling: Fair · Chills, Headache, Joint pains, Fatigue or tiredness

Free text: Headaches come daily around 1-2pm (I take a 650 MG Tylenol every morning before work.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Dizzy much of the day

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — day 7, dose 2
MedDRA: Arthralgia, Neck pain — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Neck & shoulder pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-19
Survey response — day 21, dose 2
MedDRA: Arthralgia, Dyspnoea, Insomnia, Night sweats, Self-medication — Feeling: Fair

Free text: Night sweats and some insomnia.. still have arthritis like pain, back, neck & hands manage with Tylenol I have noticed some shortness of breath walking since first vaccine, but attributed it to quick walk & it subsides when I rest.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-05
Survey response — day 35, dose 2
MedDRA: Arthralgia — Feeling: Fair

Free text: Increased joint pain in my knees, ankles and hands

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-04-30
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-07-03
Dose 3 — Moderna
2021-07-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-29
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-09-23
Dose 4 — Moderna
2022-10-11
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-14
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-21
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-28
Survey response — day 35, dose 4
MedDRA: Cough, Night sweats — Feeling: Fair

Free text: Cough, night sweats

MedDRA releases: 2024-11 · check-in free text available
2022-11-04
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-12-23
Survey response — 3 months, dose 4
MedDRA: Asthenia, Mobility decreased, SARS-CoV-2 test positive — Feeling: Fair · Be unable to do your normal daily activities

Free text: Positive COVID self test on Sunday Dec 18? much better now. I was In bed 1 -2 days& energy started returning yesterday. Short course, will retest to see if any status change in test results.

MedDRA releases: 2024-11 · check-in free text available
2023-03-24
Survey response — 6 months, dose 4
MedDRA: Cough, Cystitis, Ear pain, Oropharyngeal pain, SARS-CoV-2 test negative, Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-03-24
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-03-27
Call 1 — Requested Callback
2023-03-28
Callback requested for
2023-03-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-30	Moderna
2	2021-01-29	Moderna
3	2021-07-03	Moderna	No
4	2022-09-23	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-31

Systemic reaction (other): Headache was limited to the left side of my head. Injection was on left arm. Also a achy feeling in left shoulder and left side of neck. Subsided with Tylenol.

2021-01-04

Systemic reaction (other): Sinus drainage increase this past week .. maybe some sinusitis

2021-01-05

Systemic reaction (other): Joint pain in hands, wrists, shoulder & knees

Release 3 — day 0, dose 2

2021-01-29

Systemic reaction (other): Night sweats, stuffy head/nose Joint pain more noticeable in a.m.

Release 3 — days 1–6 daily, dose 2

2021-02-01

Systemic reaction (other): Seem to be a bit unsteady. Not really dizzy, but unbalanced feeling.

2021-02-02

Systemic reaction (other): Have trouble focusing mind when on task.

2021-02-03

Systemic reaction (other): Headaches come daily around 1-2pm (I take a 650 MG Tylenol every morning before work.

2021-02-04

Systemic reaction (other): Dizzy much of the day

Release 3 — day 7, dose 2

2021-02-05

Systemic reaction (other): Neck & shoulder pain

Release 4 — day 21, dose 2

2021-02-19

Symptoms: Night sweats and some insomnia.. still have arthritis like pain, back, neck & hands manage with Tylenol I have noticed some shortness of breath walking since first vaccine, but attributed it to quick walk & it subsides when I rest.

Release 5 — day 35, dose 2

2021-03-05

Symptoms: Increased joint pain in my knees, ankles and hands

Release 12 — day 35, dose 4

2022-10-28

Symptoms: Cough, night sweats

Release 12 — 3 months, dose 4

2022-12-23

Symptoms: Positive COVID self test on Sunday Dec 18? much better now. I was In bed 1 -2 days& energy started returning yesterday. Short course, will retest to see if any status change in test results.

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	Arthralgia	✓	✓	✓
SD	Asthenia	·	·	✓
SD	Cough	·	·	✓
SD	Cystitis	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Ear pain	·	·	✓
SD	Insomnia	✓	✓	✓
SD	Mobility decreased	·	·	✓
SD	Night sweats	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Self-medication	✓	✓	✓
SD	Sinusitis	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Balance disorder	✓	✓	✓
SRO	Disturbance in attention	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Head discomfort	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Night sweats	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Paranasal sinus hypersecretion	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Sinus operation	○	○	○
SRO	Sinusitis	○	○	○

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