6YJ-62926-25990

2 vaccinations 12 coded responses 24 check-ins 12 free-text entries 0 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 983 / WA
Registered: 2021-01-27

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-01-27
Registered in v-safe
2021-01-27
Dose 1 — Moderna
2021-01-27
Survey response — day 0, dose 1
MedDRA: No adverse event — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-01-29
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Initial injection1/26/21

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-02
Survey response — days 1–6 daily, dose 1
MedDRA: Influenza like illness — Feeling: Fair · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Feels like flu sxs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — day 7, dose 1
MedDRA: No adverse event — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Roof leak, exposure to dampness and mold .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-17
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-02
Dose 2 — Moderna
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Lymph node pain, Lymphadenopathy, Musculoskeletal stiffness, Neck pain, Oropharyngeal pain — Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Swollen,tender lymph nodes below both clavicle s, sore throat, stiff, painful neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Swollen nodes over left clavicle

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Enlarged painful lymph nodes under left clavicle, smaller in size

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good · Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Enlarged lymph nodes @R Clavicle, less sensitive

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-09
Health check-in — day 7, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-16
Survey response — day 14, dose 2
MedDRA: Feeling hot, Pain, Pre-existing disease, Sciatica — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: Old lumbar and left injury causing extreme pain, no weight bearing or walking . Initial trauma was 2 bd week of July 2020, warm to touch . Recently pain on right same areas from compromised . Bilateral sciatica. Worst on right . Did notify primary

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-30
Survey response — day 28, dose 2
MedDRA: Arthralgia, Back pain, Fatigue, Myalgia, Skin warm, Swelling — Feeling: Good · Be unable to do your normal daily activities

Free text: Severe low back pain and both hips , swollen and warm to touch . General fatigue and myalgia.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — day 35, dose 2
MedDRA: Fall, Injury, Joint injury — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Injury to lower lumbar and left hip, diagnostic in process. Non-Covid related . Injury is 2 multiple falls with in last 8 mons. Falls are being addressed .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — day 42, dose 2
MedDRA: Arthralgia, Dysstasia, Erythema, Gait disturbance, Joint swelling, Limb injury, Sciatica, Sitting disability, Weight bearing difficulty — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Injury L upper leg, L hip pain, redness and swelling iliac sacrum joint with sciatica . Non weight bearing , difficult ambulate , sit , or stand . R side mimics sxs but less 2 compensation. Seeking medical Tx.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-31
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-27	Moderna
2	2021-03-02	Moderna

Free text

Release 2 — day 0, dose 1

2021-01-27

Systemic reaction (other): No

Release 3 — days 1–6 daily, dose 1

2021-01-29

Systemic reaction (other): Initial injection1/26/21

2021-02-02

Systemic reaction (other): Feels like flu sxs

Release 3 — day 7, dose 1

2021-02-03

Systemic reaction (other): Roof leak, exposure to dampness and mold .

Release 5 — days 1–6 daily, dose 2

2021-03-04

Systemic reaction (other): Swollen,tender lymph nodes below both clavicle s, sore throat, stiff, painful neck

2021-03-05

Systemic reaction (other): Swollen nodes over left clavicle

2021-03-06

Systemic reaction (other): Enlarged painful lymph nodes under left clavicle, smaller in size

2021-03-07

Systemic reaction (other): Enlarged lymph nodes @R Clavicle, less sensitive

Release 5 — day 14, dose 2

2021-03-16

Symptoms: Old lumbar and left injury causing extreme pain, no weight bearing or walking . Initial trauma was 2 bd week of July 2020, warm to touch . Recently pain on right same areas from compromised . Bilateral sciatica. Worst on right . Did notify primary cut off by CDC

Release 6 — day 28, dose 2

2021-03-30

Symptoms: Severe low back pain and both hips , swollen and warm to touch . General fatigue and myalgia.

Release 7 — day 35, dose 2

2021-04-06

Symptoms: Injury to lower lumbar and left hip, diagnostic in process. Non-Covid related . Injury is 2 multiple falls with in last 8 mons. Falls are being addressed .

Release 7 — day 42, dose 2

2021-04-14

Symptoms: Injury L upper leg, L hip pain, redness and swelling iliac sacrum joint with sciatica . Non weight bearing , difficult ambulate , sit , or stand . R side mimics sxs but less 2 compensation. Seeking medical Tx.

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	Arthralgia	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Dysstasia	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Fall	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling hot	✓	✓	✓
SD	Gait disturbance	✓	✓	✓
SD	Injury	✓	✓	✓
SD	Joint injury	✓	✓	✓
SD	Joint swelling	✓	✓	✓
SD	Limb injury	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Sciatica	✓	✓	✓
SD	Sitting disability	✓	✓	✓
SD	Skin warm	✓	✓	✓
SD	Swelling	✓	✓	✓
SD	Weight bearing difficulty	✓	✓	✓
SRO	Influenza like illness	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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