E63-28224-34048

4 vaccinations 19 coded responses 54 check-ins 17 free-text entries 1 call case

Sex: Female
Age at first dose: 36-40
ZIP prefix: 523 / IA
Registered: 2021-04-29

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

Registered dependents

2CU-12459-85074 Child or adolescent in my care · Male · 2022-07-15

LYV-13063-40684 Child or adolescent in my care · Female · 2022-07-15

Timeline

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

2021-04-29
Registered in v-safe
2021-04-29
Dose 1 — Moderna
2021-04-29
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness

Adult check-in
2021-04-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-05-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-05-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-05-03
Survey response — days 1–6 daily, dose 1
MedDRA: Eye pruritus, Foreign body sensation in eyes — Feeling: Good

Free text: Eyes itching- feels like sandpaper

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-05-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-05-06
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-05-13
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-27
Dose 2 — Moderna
2021-05-27
Survey response — day 0, dose 2
MedDRA: Musculoskeletal pain — Feeling: Fair · Site: Pain · Muscle or body aches

Free text: My shot was given on the back part of my arm, slightly behind my shoulder bone. My arm isnt too bad (bicep area), but my entire shoulder blade hurts.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Survey response — days 1–6 daily, dose 2
MedDRA: Dyskinesia, Musculoskeletal pain, Product administered at inappropriate site — Feeling: Poor · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Shot had to be given in wrong place. Cant open moth too wide, make certain faces, lean over at all. My entire left should let blade is excruciating.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-29
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Musculoskeletal pain — Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness

Free text: Still a very sore shoulder blade pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-30
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Musculoskeletal pain — Feeling: Good · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Should blade muscle is still sore, but it has went down in pain. So it seems to be improving.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Chills, Fatigue or tiredness

Adult check-in
2021-06-01
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: Shoulder is still a bit sore to sleep on.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-06-03
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-06-10
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-17
Survey response — day 21, dose 2
MedDRA: Axillary pain, Breast discomfort, Breast pain, Injection site pain, Limb discomfort, Musculoskeletal pain, Sleep disorder — Feeling: Fair

Free text: Top of left shoulder and shoulder blade started hurting again (shot arm). Hurt a tad when sleeping, and a constant today. Also, under left armpit/side of breast have felt some deeper pain/discomfort. Started on the weekend- nearly a daily thing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-07-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-07-08
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-08-26
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-03
Dose 3 — Moderna
Co-administered: Flu
2021-12-03
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-12-04
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-12-05
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Breast pain — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Under left arm (covid booster arm), under the armpit and left side of breast is aching and very sore.

MedDRA releases: 2024-11 · check-in free text available
2021-12-06
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Breast pain — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Still very sore under the left armpit and side of the left breast (arm that received the covid booster).

MedDRA releases: 2024-11 · check-in free text available
2021-12-07
Survey response — days 1–6 daily, dose 3
MedDRA: Breast tenderness, Oropharyngeal pain, Sensation of foreign body, Tenderness — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Still pretty tender under left armpit and side of left breast (covid booster arm). Woke yesterday and today with a sore spot that felt like a lump in the right side of my throat. Yesterday it went away, but today it has been there all day!

MedDRA releases: 2024-11 · check-in free text available
2021-12-08
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Breast pain, Dizziness, Dry throat, Oropharyngeal pain — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Still a tad sore under the armpit and left side of my breast (booster shot arm). Still a bit of a dry sore throat, but today is a bit better. Seems slightly dizzy if overdoing myself (cell phone, kids, reading, etc all at once).

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Breast pain, Odynophagia, Oesophageal pain — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Very faint pain under armpit/left breast. Still sore at times when I swallow (but seems more in the esophagus than my actual throat).

MedDRA releases: 2024-11 · check-in free text available
2021-12-10
Survey response — day 7, dose 3
MedDRA: Aphthous ulcer, Neck pain, Oropharyngeal pain — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Still a bit sore in right side of my throat and neck (but did see a canker sore on the back of my throat on the right side).

MedDRA releases: 2024-11 · check-in free text available
2021-12-17
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-31
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-07
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-14
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-04
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-03
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-04
Dose 4 — Moderna
Co-administered: Flu
2022-11-05
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-11-06
Survey response — days 1–6 daily, dose 4
MedDRA: Myalgia — Feeling: Fair · Site: Pain, Redness · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Free text: Very sore muscle pain along left breast and under armpit (where the 2 meet).

MedDRA releases: 2024-11 · check-in free text available
2022-11-07
Survey response — days 1–6 daily, dose 4
MedDRA: Axillary pain, Breast pain — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Still hurting and sore under the armpit and on the side of left breast (where they connect to each other).

MedDRA releases: 2024-11 · check-in free text available
2022-11-08
Survey response — days 1–6 daily, dose 4
MedDRA: Axillary pain, Breast pain — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Pain meds under left arm, where armpit and left breast meet. Has slightly gotten better.

MedDRA releases: 2024-11 · check-in free text available
2022-11-09
Survey response — days 1–6 daily, dose 4
MedDRA: Axillary pain, Discomfort — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Still some slight discomfort under the armpit where it meets the breast. Has improved a lot though.

MedDRA releases: 2024-11 · check-in free text available
2022-11-10
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-11-11
Health check-in — day 7, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-11-18
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-11-25
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-12-02
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-12-09
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-12-16
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2023-02-03
Survey response — 3 months, dose 4
MedDRA: Headache — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-05-05
Survey response — 6 months, dose 4
MedDRA: Headache, Pre-existing disease, Unevaluable event — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-05-05
Report sent to call center — 6 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2023-05-08
Call 1 — Left Voicemail
2023-05-09
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-29	Moderna
2	2021-05-27	Moderna
3	2021-12-03	Moderna	Flu
4	2022-11-04	Moderna	Flu

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 8 — days 1–6 daily, dose 1

2021-05-03

Systemic reaction (other): Eyes itching- feels like sandpaper

Release 8 — day 0, dose 2

2021-05-27

Systemic reaction (other): My shot was given on the back part of my arm, slightly behind my shoulder bone. My arm isnt too bad (bicep area), but my entire shoulder blade hurts.

Release 8 — days 1–6 daily, dose 2

2021-05-28

Systemic reaction (other): Shot had to be given in wrong place. Cant open moth too wide, make certain faces, lean over at all. My entire left should let blade is excruciating.

2021-05-29

Systemic reaction (other): Still a very sore shoulder blade pain.

2021-05-30

Systemic reaction (other): Should blade muscle is still sore, but it has went down in pain. So it seems to be improving.

2021-06-01

Systemic reaction (other): Shoulder is still a bit sore to sleep on.

Release 9 — day 21, dose 2

2021-06-17

Symptoms: Top of left shoulder and shoulder blade started hurting again (shot arm). Hurt a tad when sleeping, and a constant today. Also, under left armpit/side of breast have felt some deeper pain/discomfort. Started on the weekend- nearly a daily thing.

Release 10 — days 1–6 daily, dose 3

2021-12-05

Systemic reaction (other): Under left arm (covid booster arm), under the armpit and left side of breast is aching and very sore.

2021-12-06

Systemic reaction (other): Still very sore under the left armpit and side of the left breast (arm that received the covid booster).

2021-12-07

Systemic reaction (other): Still pretty tender under left armpit and side of left breast (covid booster arm). Woke yesterday and today with a sore spot that felt like a lump in the right side of my throat. Yesterday it went away, but today it has been there all day!

2021-12-08

Systemic reaction (other): Still a tad sore under the armpit and left side of my breast (booster shot arm). Still a bit of a dry sore throat, but today is a bit better. Seems slightly dizzy if overdoing myself (cell phone, kids, reading, etc all at once).

2021-12-09

Systemic reaction (other): Very faint pain under armpit/left breast. Still sore at times when I swallow (but seems more in the esophagus than my actual throat).

Release 10 — day 7, dose 3

2021-12-10

Systemic reaction (other): Still a bit sore in right side of my throat and neck (but did see a canker sore on the back of my throat on the right side).

Release 12 — days 1–6 daily, dose 4

2022-11-06

Systemic reaction (other): Very sore muscle pain along left breast and under armpit (where the 2 meet).

2022-11-07

Systemic reaction (other): Still hurting and sore under the armpit and on the side of left breast (where they connect to each other).

2022-11-08

Systemic reaction (other): Pain meds under left arm, where armpit and left breast meet. Has slightly gotten better.

2022-11-09

Systemic reaction (other): Still some slight discomfort under the armpit where it meets the breast. Has improved a lot though.

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	Unevaluable event	·	·	✓
SD	Axillary pain	✓	✓	✓
SD	Breast discomfort	✓	✓	✓
SD	Breast pain	✓	✓	✓
SD	Headache	·	·	✓
SD	Injection site pain	✓	✓	✓
SD	Limb discomfort	✓	✓	✓
SD	Musculoskeletal pain	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Sleep disorder	✓	✓	✓
SRO	Aphthous ulcer	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Axillary pain	·	·	✓
SRO	Breast pain	·	·	✓
SRO	Breast tenderness	·	·	✓
SRO	Discomfort	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Dry throat	·	·	✓
SRO	Dyskinesia	✓	✓	✓
SRO	Eye pruritus	✓	✓	✓
SRO	Foreign body sensation in eyes	✓	✓	✓
SRO	Movement disorder	○	○	○
SRO	Musculoskeletal pain	✓	✓	✓
SRO	Myalgia	·	·	✓
SRO	Neck pain	·	·	✓
SRO	Odynophagia	·	·	✓
SRO	Oesophageal pain	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Product administered at inappropriate site	✓	✓	✓
SRO	Sensation of foreign body	·	·	✓
SRO	Tenderness	·	·	✓
SRO	Trismus	○	○	○

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