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6ES-31174-75970

2 vaccinations 8 coded responses 23 check-ins 8 free-text entries 0 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
543 / WI
Registered
2021-06-11
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
EGD-26301-09167 Other · Male · 2021-08-09

Timeline

  1. 2021-06-11
    Registered in v-safe
  2. 2021-06-11
    Dose 1 — Moderna
  3. 2021-06-11
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-06-12
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pain in extremity — Feeling: Good · Site: Pain
    Free text: Just arm pain started 12 hours after given the shot
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-06-13
    Survey response — days 1–6 daily, dose 1
    MedDRA: Adverse reaction — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: Symptoms got worse 24 hours after the shot.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-06-14
    Survey response — days 1–6 daily, dose 1
    MedDRA: Limb discomfort — Feeling: Good · Site: Pain · Fatigue or tiredness
    Free text: Arm is getting better. Still a little tied.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-06-15
    Survey response — days 1–6 daily, dose 1
    MedDRA: Injection site pain — Feeling: Good · Site: Pain · Joint pains
    Free text: Just still sore in the muscle the vaccine was given. NEVER had pain from a shot before. But its getting somewhat better.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-06-16
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pain in extremity — Feeling: Good · Site: Pain
    Free text: Still soreness in the arm. Getting better but still some sensitivity
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-06-17
    Survey response — days 1–6 daily, dose 1
    MedDRA: Adverse reaction — Feeling: Good · Site: Pain
    Free text: Almost gone
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-06-18
    Survey response — day 7, dose 1
    MedDRA: Pain in extremity — Feeling: Good
    Free text: One week and the arm pain is 90% better.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-06-25
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-07-02
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-07-09
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  14. 2021-07-12
    Dose 2 — Moderna
  15. 2021-07-16
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  16. 2021-07-17
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  17. 2021-07-18
    Survey response — days 1–6 daily, dose 2
    MedDRA: Malaise — Feeling: Good
    Free text: Its been 6 days since my shot. Started receiving this questionnaire 5 days after my second dose. Was sick the 3 days after. Now Im better.
    MedDRA releases: 2024-11 · check-in free text available
  18. 2021-07-19
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-07-26
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-08-02
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-08-09
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-08-16
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-08-23
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-10-11
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  25. 2022-01-10
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  26. 2022-07-12
    Health check-in — 12 months, dose 2
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-06-11Moderna
22021-07-12Moderna No

Free text

Release 9 — days 1–6 daily, dose 1

2021-06-12

Systemic reaction (other): Just arm pain started 12 hours after given the shot

2021-06-13

Systemic reaction (other): Symptoms got worse 24 hours after the shot.

2021-06-14

Systemic reaction (other): Arm is getting better. Still a little tied.

2021-06-15

Systemic reaction (other): Just still sore in the muscle the vaccine was given. NEVER had pain from a shot before. But its getting somewhat better.

2021-06-16

Systemic reaction (other): Still soreness in the arm. Getting better but still some sensitivity

2021-06-17

Systemic reaction (other): Almost gone

Release 9 — day 7, dose 1

2021-06-18

Systemic reaction (other): One week and the arm pain is 90% better.

Release 9 — days 1–6 daily, dose 2

2021-07-18

Systemic reaction (other): Its been 6 days since my shot. Started receiving this questionnaire 5 days after my second dose. Was sick the 3 days after. Now Im better.

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

FieldPreferred term2021-092023-042024-11
SROAdverse reaction ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SROLimb discomfort ✓ ✓ ✓
SROMalaise · · ✓
SROPain in extremity ✓ ✓ ✓

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

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