6UG-15232-98743

2 vaccinations 6 coded responses 22 check-ins 6 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 857 / AZ
Registered: 2021-02-11

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

2021-02-11
Registered in v-safe
2021-02-11
Dose 1 — Moderna
2021-02-11
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-13
Survey response — days 1–6 daily, dose 1
MedDRA: Muscle spasms, Pain in extremity — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · 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: Left calf pain with cramping

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-15
Survey response — days 1–6 daily, dose 1
MedDRA: Deep vein thrombosis, Emergency care, Pain in extremity — Feeling: Fair · Fatigue or tiredness · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: I had my1st Moderna shot in the AM 2/11/21. That evening I developed left calf pain. On 2/13/21 I was seen in ER and, post an ultrsound, diagnosed with a deep vein theombosis (DVT). I am now on Eliquist. I doubt it was related ro the shot but did want to pass the info on.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-16
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Muscle or body aches

Free text: The pain in my left calf from the DVT has greatly decreased.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-13
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-15
Dose 2 — Moderna
2021-03-18
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Chills, Derealisation, Fatigue, Headache, Nausea, Pain in extremity, Pyrexia — Feeling: Good · Fatigue or tiredness

Free text: I felt louay on the 16th with fever, chills, severe back, arm, leg pain marked fatigue, headache, nausea - today back to normal except mild fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-21
Survey response — days 1–6 daily, dose 2
MedDRA: Confusional state, Dehydration, Dizziness — Feeling: Poor · Headache, Nausea · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Lightheaded, confused · Healthcare visit (other): Our local fire dept will do health checks. We think I got dehydrated. Vitals were OK except B/P indicated dehydration. Now rehydrating & doing better.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-24
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-29
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-19
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-26
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-15
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-30
Call 1 — Left Voicemail
2021-09-14
Survey response — 6 months, dose 2
MedDRA: Flank pain — 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: Right sided flank pain of unknown origin.

MedDRA releases: 2024-11 · check-in free text available
2021-09-14
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)
2021-09-16
Call 1 — Left Voicemail
2022-03-18
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-11	Moderna
2	2021-03-15	Moderna

Call center

4 call center cases

4 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-13

Systemic reaction (other): Left calf pain with cramping

2021-02-15

Systemic reaction (other): I had my1st Moderna shot in the AM 2/11/21. That evening I developed left calf pain. On 2/13/21 I was seen in ER and, post an ultrsound, diagnosed with a deep vein theombosis (DVT). I am now on Eliquist. I doubt it was related ro the shot but did want to pass the info on.

2021-02-16

Systemic reaction (other): The pain in my left calf from the DVT has greatly decreased.

Release 5 — days 1–6 daily, dose 2

2021-03-18

Systemic reaction (other): I felt louay on the 16th with fever, chills, severe back, arm, leg pain marked fatigue, headache, nausea - today back to normal except mild fatigue

Release 6 — days 1–6 daily, dose 2

2021-03-21

Systemic reaction (other): Lightheaded, confused

Healthcare visit (other): Our local fire dept will do health checks. We think I got dehydrated. Vitals were OK except B/P indicated dehydration. Now rehydrating & doing better.

Release 9 — 6 months, dose 2

2021-09-14

Symptoms: Right sided flank pain of unknown origin.

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	Dehydration	✓	✓	✓
SD	Flank pain	·	·	✓
SRO	Back pain	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Confusional state	✓	✓	✓
SRO	Deep vein thrombosis	✓	✓	✓
SRO	Derealisation	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	○	○	○
SRO	Headache	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pyrexia	✓	✓	✓

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