6FP-12775-95354

2 vaccinations 11 coded responses 20 check-ins 11 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 770 / TX
Registered: 2021-01-09

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

2021-01-09
Registered in v-safe
2021-01-09
Dose 1 — Moderna
2021-01-09
Health check-in — day 0, dose 1
Feeling: Fair · Headache, Joint pains

Adult check-in
2021-01-10
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Fair · Site: Pain · Headache, Muscle or body aches · Be unable to do your normal daily activities

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-10
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-11
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Body aches only at injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-15
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-18
Health check-in — day 7, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-01-23
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-30
Survey response — day 21, dose 1
MedDRA: Headache, Nausea, Pre-existing disease — Feeling: Poor · Be unable to work, 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: Terrible headache and nausea probably a result of brain shunt surgery3 days ago

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Report sent to call center — day 21, dose 1
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)
2021-02-06
Dose 2 — Moderna
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Half way through the day I noticed that I was experiencing pain in the other shoulder, the shoulder where I got my first vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text:

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Free text: One week of pain in the opposite shoulder from where my 2nd vaccine was administered.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-20
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-02-27
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-06
Survey response — day 28, dose 2
MedDRA: Paralysis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Weird freezing or paralysis of muscles and joints especially across upper chest, neck and shoulders.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Survey response — day 35, dose 2
MedDRA: Arthralgia, Myalgia — Feeling: Fair

Free text: Intermittent muscular/joint jabbing pains.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — day 42, dose 2
MedDRA: Diarrhoea, Muscle rigidity — Feeling: Fair

Free text: Diarrhea & rigid muscles

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Survey response — 3 months, dose 2
MedDRA: Dyspnoea, Surgery — Feeling: Poor · Be unable to do your normal daily activities

Free text: Had sinus surgery last Friday. Can not breath.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Call successful
Completed over the phone
2021-08-07
Survey response — 6 months, dose 2
MedDRA: Foot deformity, Plantar fasciitis — Feeling: Fair

Free text: Fallen arches and plantar fasciiais

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-02-09
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-09	Moderna
2	2021-02-06	Moderna

Call center

3 call center cases

1 successful · 2 priority 2/3 (triaged and no follow up)

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-10

Systemic reaction (other): No

2021-01-11

Systemic reaction (other): Body aches only at injection site.

Release 3 — day 21, dose 1

2021-01-30

Symptoms: Terrible headache and nausea probably a result of brain shunt surgery3 days ago

Release 3 — days 1–6 daily, dose 2

2021-02-07

Systemic reaction (other): Half way through the day I noticed that I was experiencing pain in the other shoulder, the shoulder where I got my first vaccine

Release 4 — days 1–6 daily, dose 2

2021-02-11

2021-02-12

Systemic reaction (other): One week of pain in the opposite shoulder from where my 2nd vaccine was administered.

Release 5 — day 28, dose 2

2021-03-06

Symptoms: Weird freezing or paralysis of muscles and joints especially across upper chest, neck and shoulders.

Release 5 — day 35, dose 2

2021-03-13

Symptoms: Intermittent muscular/joint jabbing pains.

Release 6 — day 42, dose 2

2021-03-20

Symptoms: Diarrhea & rigid muscles

Release 8 — 3 months, dose 2

2021-05-09

Symptoms: Had sinus surgery last Friday. Can not breath.

Release 9 — 6 months, dose 2

2021-08-07

Symptoms: Fallen arches and plantar fasciiais

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	Diarrhoea	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Foot deformity	✓	·	✓
SD	Headache	✓	✓	✓
SD	Muscle rigidity	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Paralysis	✓	✓	✓
SD	Plantar fasciitis	✓	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Surgery	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Unevaluable event	○	○	○

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