6VU-76601-40594

3 vaccinations 6 coded responses 25 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 109 / NY
Registered: 2021-03-17

Relationship: Self
Race: Other
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-15
Dose 1 — Moderna
2021-03-17
Registered in v-safe
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Chills, Headache, Pain — Feeling: Fair · Site: Pain

Free text: I felt chills headache and body ache after shot on 3/15/21 through afternoon 3/16/21

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · None

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

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

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-03-22
Survey response — day 7, dose 1
MedDRA: Insomnia — Feeling: Fair · Joint pains, Muscle or body aches

Free text: Sleeplessness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Survey response — day 14, dose 1
MedDRA: Arthralgia, Back pain, Chest discomfort, Insomnia — Feeling: Fair

Free text: SleeplessnessBeck and shoulder acheTightness in chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-12
Dose 2 — Moderna
2021-04-12
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Fatigue or tiredness, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Diarrhea

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Diarrhea, Abdominal pain

Adult check-in
2021-04-18
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Dyspnoea — Feeling: Fair · Site: Pain, Redness, Itching · Chills, Headache, Joint pains, Fatigue or tiredness, Diarrhea

Free text: Breathing difficulty. Tightness around chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — day 7, dose 2
Feeling: Fair · Site: Redness · Headache, Diarrhea

Adult check-in
2021-04-26
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-03
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-12
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-11
Survey response — 6 months, dose 2
MedDRA: Back pain, Muscle spasms, Neuralgia, Office visit — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Severe back pain and spasms. On nerve pain med gabapentin and muscle spasm med robaxin. No other changes in life other than the Moderna vaccines. Not sure if related. No explanation. Had MRIs done and blood work done. · Healthcare visit (other): Various Specialists

MedDRA releases: 2024-11 · check-in free text available
2021-10-11
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-10-28
Dose 3 — Moderna
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Nausea

Adult check-in
2021-11-13
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-19
Call 1 — Left Voicemail
2022-04-30
Survey response — 6 months, dose 3
MedDRA: COVID-19 — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: COVID

MedDRA releases: 2024-11 · check-in free text available
2022-04-30
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-05-03
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-15	Moderna
2	2021-04-12	Moderna
3	2021-10-28	Moderna	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-17

Systemic reaction (other): I felt chills headache and body ache after shot on 3/15/21 through afternoon 3/16/21

Release 6 — day 7, dose 1

2021-03-22

Systemic reaction (other): Sleeplessness

Release 6 — day 14, dose 1

2021-03-30

Symptoms: SleeplessnessBeck and shoulder acheTightness in chest

Release 7 — days 1–6 daily, dose 2

2021-04-18

Systemic reaction (other): Breathing difficulty. Tightness around chest

Release 10 — 6 months, dose 2

2021-10-11

Symptoms: Severe back pain and spasms. On nerve pain med gabapentin and muscle spasm med robaxin. No other changes in life other than the Moderna vaccines. Not sure if related. No explanation. Had MRIs done and blood work done.

Healthcare visit (other): Various Specialists

Release 11 — 6 months, dose 3

2022-04-30

Symptoms: COVID

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	COVID-19	·	·	✓
SD	Insomnia	✓	✓	✓
SD	Muscle spasms	·	·	✓
SD	Neuralgia	·	·	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Pain	✓	✓	✓

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