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6KX-54659-21496

2 vaccinations 4 coded responses 14 check-ins 4 free-text entries 1 call case
Sex
Female
Age at first dose
51-55
ZIP prefix
840 / UT
Registered
2021-03-11
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-11
    Registered in v-safe
  2. 2021-03-11
    Dose 1 — Moderna
  3. 2021-03-11
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-03-12
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  5. 2021-03-13
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  6. 2021-03-14
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-03-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-03-19
    Survey response — day 7, dose 1
    MedDRA: Back pain, Fatigue, Flatulence, Pain — Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities
    Free text: Have had abdominal gassiness, but difficult to pass. Feels like the need to have a bowel movement, but much time on the toilet doesn't produce bowel movement. I have chronic pain conditions and fatigue. Low back pain had just been a nuisance of late but thinking back the low back pain, as well as fatigue and other pain, had been heightened to quite unbearable since about the time of the vaccine. I have not reported it or made that connection until now. It is hard to know if it is me or related to the vaccine
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-03-25
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-04-08
    Dose 2 — Moderna
  11. 2021-04-15
    Survey response — day 7, dose 2
    MedDRA: Back pain, Discomfort, Dizziness, Musculoskeletal pain, Pain in extremity, Pre-existing disease — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Mild dizziness, severe lower back pain, buttock and leg ripping and tearing sensations reported even after 1st injection. I have osteoarthritis, multi degenerative joint and disc dx, fibromyalgia,,
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-04-22
    Health check-in — day 14, dose 2
    Feeling: Poor
    Adult check-in
  13. 2021-04-30
    Health check-in — day 21, dose 2
    Feeling: Poor
    Adult check-in
  14. 2021-05-06
    Health check-in — day 28, dose 2
    Feeling: Fair
    Adult check-in
  15. 2021-05-13
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-05-20
    Survey response — day 42, dose 2
    MedDRA: Migraine — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Three day migraine not improved with migraine medications. Finally starting to subside a bit today.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-07-08
    Survey response — 3 months, dose 2
    MedDRA: Arthralgia, Back pain, Chest discomfort, Hypoaesthesia, Joint noise, Musculoskeletal chest pain, Office visit, Spinal fusion surgery — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Symptoms: Hx of low back pain and fusions. New symptoms of clunking sound with certain movements causing increased pain. Having pain in left rib cage area, causing very uncomfortable tightening. Both legs are going numb. MRI of lumbar spine 7/12/2021. · Healthcare visit (other): Imaging
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-07-08
    Report sent to call center — 3 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  19. 2021-07-15

Vaccinations

DoseDateManufacturerCo-administered
12021-03-11Moderna
22021-04-08Moderna

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 6 — day 7, dose 1

2021-03-19

Systemic reaction (other): Have had abdominal gassiness, but difficult to pass. Feels like the need to have a bowel movement, but much time on the toilet doesn't produce bowel movement. I have chronic pain conditions and fatigue. Low back pain had just been a nuisance of late but thinking back the low back pain, as well as fatigue and other pain, had been heightened to quite unbearable since about the time of the vaccine. I have not reported it or made that connection until now. It is hard to know if it is me or related to the vaccine

Release 7 — day 7, dose 2

2021-04-15

Systemic reaction (other): Mild dizziness, severe lower back pain, buttock and leg ripping and tearing sensations reported even after 1st injection. I have osteoarthritis, multi degenerative joint and disc dx, fibromyalgia,,

Release 8 — day 42, dose 2

2021-05-20

Symptoms: Three day migraine not improved with migraine medications. Finally starting to subside a bit today.

Release 9 — 3 months, dose 2

2021-07-08

Symptoms: Hx of low back pain and fusions. New symptoms of clunking sound with certain movements causing increased pain. Having pain in left rib cage area, causing very uncomfortable tightening. Both legs are going numb. MRI of lumbar spine 7/12/2021.
Healthcare visit (other): Imaging

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
HCVOOffice visit ✓ ✓ ✓
SDArthralgia ✓ ✓ ✓
SDBack pain ✓ ✓ ✓
SDChest discomfort ✓ ✓ ✓
SDHypoaesthesia ✓ ✓ ✓
SDJoint noise ✓ ✓ ✓
SDMigraine ✓ ✓ ✓
SDMusculoskeletal chest pain ✓ ✓ ✓
SDSpinal fusion surgery ✓ ✓ ✓
SROBack pain ✓ ✓ ✓
SRODiscomfort ✓ ✓ ✓
SRODizziness ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROFlatulence ✓ ✓ ✓
SROMusculoskeletal pain ✓ ✓ ✓
SROPain ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓

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