65M-31649-46807

4 vaccinations 9 coded responses 32 check-ins 8 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 920 / CA
Registered: 2021-02-28

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

2021-02-01
Dose 1 — Moderna
2021-02-28
Registered in v-safe
2021-03-01
Dose 2 — Moderna
2021-03-01
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Muscle or body aches · Be unable to do your normal daily activities

Free text: I took naproxsin sodium & Allegra for back & arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Sciatica, Self-medication — Feeling: Good · Site: Redness, Swelling, Itching

Free text: I took Benadryl last night and Allegra and 3 Advil this morning. The Advil was for my back & sciatica.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease, Self-medication — Feeling: Good · Site: Redness, Swelling, Itching · Muscle or body aches

Free text: Back aches are normal for me. Antihistamines are helping the arm, I think.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — day 7, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-03-15
Survey response — day 14, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities

Free text: It seems like sciatica. I landed on my backside after missing a stair step. I hit a cement wall. I have a call in to my doctor. In my opinion it has nothing to do with the vaccine or COVID.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — day 21, dose 2
MedDRA: Arthralgia, Back pain, Fall, Sciatica — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Sciatica, hip & back pain, probably related to a fall on 2/24.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Report sent to call center — day 21, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-31
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-30
Survey response — 6 months, dose 2
MedDRA: Arthropathy, Back disorder, Fall — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Back & hip problems probably related to a partial fall.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-30
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)
2021-08-31
Call 2 — Left Voicemail
2021-08-31
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-08-31
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-09-08
Dose 3 — Moderna
2021-10-25
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-08
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-09
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-04-18
Dose 4 — Moderna
2022-04-19
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2022-04-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-04-22
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness · None

Adult check-in
2022-04-23
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2022-04-25
Health check-in — day 7, dose 4
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2022-05-02
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-09
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-16
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-23
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-30
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-18
Survey response — 3 months, dose 4
MedDRA: Spinal compression fracture — Feeling: Good · 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: New compression fracture in my spine.

MedDRA releases: 2024-11 · check-in free text available
2022-07-18
Report sent to call center — 3 months, dose 4
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)
2022-07-19
Call 1 — Left Voicemail
2022-07-19
Call 1 — Left Voicemail
2022-07-19
Call 1 — Left Voicemail
2022-07-19
Callback requested for
06:00PM ET
2022-07-19
Call successful
Not applicable - Accidental Reporting
2022-10-17
Survey response — 6 months, dose 4
MedDRA: Atrial fibrillation — 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: I was diagnosed with A-fib.

MedDRA releases: 2024-11 · check-in free text available
2022-10-17
Report sent to call center — 6 months, dose 4
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)
2022-10-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-18
Survey response — 12 months, dose 4
MedDRA: Pathogen resistance, Pneumonia pseudomonal — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-04-18
Report sent to call center — 12 months, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-04-19
Call 1 — Left Voicemail
2023-04-21
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	2021-02-01	Moderna
2	2021-03-01	Moderna
3	2021-09-08	Moderna	No
4	2022-04-18	Moderna	No

Call center

5 call center cases

5 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-04

Systemic reaction (other): I took naproxsin sodium & Allegra for back & arm.

2021-03-06

Systemic reaction (other): I took Benadryl last night and Allegra and 3 Advil this morning. The Advil was for my back & sciatica.

2021-03-07

Systemic reaction (other): Back aches are normal for me. Antihistamines are helping the arm, I think.

Release 5 — day 14, dose 2

2021-03-15

Symptoms: It seems like sciatica. I landed on my backside after missing a stair step. I hit a cement wall. I have a call in to my doctor. In my opinion it has nothing to do with the vaccine or COVID.

Release 6 — day 21, dose 2

2021-03-22

Symptoms: Sciatica, hip & back pain, probably related to a fall on 2/24.

Release 9 — 6 months, dose 2

2021-08-30

Symptoms: Back & hip problems probably related to a partial fall.

Release 12 — 3 months, dose 4

2022-07-18

Symptoms: New compression fracture in my spine.

Release 12 — 6 months, dose 4

2022-10-17

Symptoms: I was diagnosed with A-fib.

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	Arthropathy	✓	·	✓
SD	Atrial fibrillation	·	·	✓
SD	Back disorder	✓	·	✓
SD	Back pain	✓	✓	✓
SD	Fall	✓	·	✓
SD	Pathogen resistance	·	·	✓
SD	Pneumonia pseudomonal	·	·	✓
SD	Sciatica	✓	✓	✓
SD	Spinal compression fracture	·	·	✓
SD	Unevaluable event	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Sciatica	✓	✓	✓
SRO	Self-medication	✓	✓	✓

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