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
-
2021-03-11
Registered in v-safe
-
2021-03-11
Dose 1 — Moderna
- 2021-03-11
-
2021-03-12
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-13
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-14
- 2021-03-17
-
2021-03-19
Survey response — day 7, dose 1MedDRA: 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 activitiesFree 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 vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-25
-
2021-04-08
Dose 2 — Moderna
-
2021-04-15
Survey response — day 7, dose 2MedDRA: 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 activitiesFree 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
- 2021-04-22
- 2021-04-30
- 2021-05-06
- 2021-05-13
-
2021-05-20
Survey response — day 42, dose 2MedDRA: Migraine — Feeling: Poor · Be unable to do your normal daily activitiesFree 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
-
2021-07-08
Survey response — 3 months, dose 2MedDRA: 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 visitFree 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): ImagingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-07-08
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-11 | Moderna | |
| 2 | 2021-04-08 | Moderna |
Call center
1 call center case
1 unsuccessful
Free text
Release 6 — day 7, dose 1
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
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
Symptoms: Three day migraine not improved with migraine medications. Finally starting to subside a bit today.
Release 9 — 3 months, dose 2
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Back pain | ✓ | ✓ | ✓ |
| SD | Chest discomfort | ✓ | ✓ | ✓ |
| SD | Hypoaesthesia | ✓ | ✓ | ✓ |
| SD | Joint noise | ✓ | ✓ | ✓ |
| SD | Migraine | ✓ | ✓ | ✓ |
| SD | Musculoskeletal chest pain | ✓ | ✓ | ✓ |
| SD | Spinal fusion surgery | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Discomfort | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Flatulence | ✓ | ✓ | ✓ |
| SRO | Musculoskeletal pain | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release