6XA-28716-34181

2 vaccinations 17 coded responses 23 check-ins 17 free-text entries 5 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 464 / IN
Registered: 2021-09-25

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline

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

2021-09-24
Dose 1 — Moderna
2021-09-25
Registered in v-safe
2021-09-25
Survey response — days 1–6 daily, dose 1
MedDRA: Pain, Pain in jaw — Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Pain that goes into jaw and down side

MedDRA releases: 2024-11 · check-in free text available
2021-09-25
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

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
2021-09-26
Survey response — days 1–6 daily, dose 1
MedDRA: Flank pain — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Pain in left side

MedDRA releases: 2024-11 · check-in free text available
2021-09-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-09-28
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain, Flank pain — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Pain in left side and back

MedDRA releases: 2024-11 · check-in free text available
2021-09-28
Call 1 — Left Voicemail
2021-09-29
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Left back pain and some pain into beck comes and goes

MedDRA releases: 2024-11 · check-in free text available
2021-09-30
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain, Flank pain, Neck pain — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Left side and back pain that goes into the neck

MedDRA releases: 2024-11 · check-in free text available
2021-10-01
Survey response — day 7, dose 1
MedDRA: Back pain, Pain in jaw — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Left side pain into back and up into jaw

MedDRA releases: 2024-11 · check-in free text available
2021-10-08
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-10-15
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-10-24
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-10-29
Dose 2 — Moderna
2021-10-29
Survey response — day 0, dose 2
MedDRA: Chest discomfort, Neck pain — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Chest tightness and neck pain

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Neck pain, Wheezing — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Left side neck pain/chest tightness/wheezing

MedDRA releases: 2024-11 · check-in free text available
2021-10-31
Survey response — days 1–6 daily, dose 2
MedDRA: Burning sensation, Chest discomfort, Limb mass, Neck pain — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Chest tightness/left neck pain/lump in arm/burning

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Injection site mass, Neck pain — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Chest tightness/left neck pain/lump at injection

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Injection site mass, Neck pain — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Left neck pain/chest tightness/lump at injection site

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Report sent to call center — days 1–6 daily, 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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-03
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Injection site mass, Neck pain — Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Neck pain/lump at injection chest tightness

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Report sent to call center — days 1–6 daily, 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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-03
Call 1 — Left Voicemail
2021-11-04
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Injection site mass, Neck pain — Feeling: Good · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Chest tightness/left neck pain/lump at injection

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Call 1 — Left Voicemail
2021-11-06
Survey response — day 7, dose 2
MedDRA: Chest discomfort, Injection site mass, Neck pain, Wheezing — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Chest tightness/left neck pain/lump at injection and wheezing

MedDRA releases: 2024-11 · check-in free text available
2021-11-14
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-11-19
Survey response — day 21, dose 2
MedDRA: Chest discomfort — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Chest tightness

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-24
Call 1 — Left Voicemail
2021-11-26
Survey response — day 28, dose 2
MedDRA: Chest pain, Pain in extremity, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activities

Free text: Congestion and burning in chest Persistent pain in L arm

MedDRA releases: 2024-11 · check-in free text available
2021-12-05
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2022-01-28
Survey response — 3 months, dose 2
MedDRA: COVID-19 — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Covid

MedDRA releases: 2024-11 · check-in free text available
2022-01-28
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-02-01
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-09-24	Moderna	No
2	2021-10-29	Moderna	No

Call center

5 call center cases

5 unsuccessful

See the call center timeline

Free text

Release 9 — days 1–6 daily, dose 1

2021-09-25

Systemic reaction (other): Pain that goes into jaw and down side

2021-09-26

Systemic reaction (other): Pain in left side

2021-09-28

Systemic reaction (other): Pain in left side and back

2021-09-29

Systemic reaction (other): Left back pain and some pain into beck comes and goes

2021-09-30

Systemic reaction (other): Left side and back pain that goes into the neck

Release 9 — day 7, dose 1

2021-10-01

Systemic reaction (other): Left side pain into back and up into jaw

Release 10 — day 0, dose 2

2021-10-29

Systemic reaction (other): Chest tightness and neck pain

Release 10 — days 1–6 daily, dose 2

2021-10-30

Systemic reaction (other): Left side neck pain/chest tightness/wheezing

2021-10-31

Systemic reaction (other): Chest tightness/left neck pain/lump in arm/burning

2021-11-01

Systemic reaction (other): Chest tightness/left neck pain/lump at injection

2021-11-02

Systemic reaction (other): Left neck pain/chest tightness/lump at injection site

2021-11-03

Systemic reaction (other): Neck pain/lump at injection chest tightness

2021-11-04

Systemic reaction (other): Chest tightness/left neck pain/lump at injection

Release 10 — day 7, dose 2

2021-11-06

Systemic reaction (other): Chest tightness/left neck pain/lump at injection and wheezing

Release 10 — day 21, dose 2

2021-11-19

Symptoms: Chest tightness

Release 10 — day 28, dose 2

2021-11-26

Symptoms: Congestion and burning in chest Persistent pain in L arm

Release 11 — 3 months, dose 2

2022-01-28

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
SD	Chest discomfort	·	·	✓
SD	Chest pain	·	·	✓
SD	COVID-19	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SRO	Back pain	·	·	✓
SRO	Burning sensation	·	·	✓
SRO	Chest discomfort	·	·	✓
SRO	Flank pain	·	·	✓
SRO	Injection site mass	·	·	✓
SRO	Limb mass	·	·	✓
SRO	Neck pain	·	·	✓
SRO	Pain	·	·	✓
SRO	Pain in jaw	·	·	✓
SRO	Wheezing	·	·	✓

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