YDD-41570-59768

4 vaccinations 16 coded responses 41 check-ins 15 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 233 / VA
Registered: 2021-01-15

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-01-14
Dose 1 — Moderna
2021-01-15
Registered in v-safe
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Site: Pain · Headache

Free text: None

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection site

Adult check-in
2021-01-23
Health check-in — day 7, dose 1
Feeling: Fair · Chills, Muscle or body aches

Adult check-in
2021-01-28
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-11
Dose 2 — Moderna
2021-02-11
Health check-in — day 0, dose 2
Feeling: Good · Headache, Muscle or body aches, Abdominal pain

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Ocular hyperaemia, Photophobia — Feeling: Good · Headache

Free text: Right eye red and sensitive to light.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Chills, Fatigue or tiredness

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-04
Survey response — day 21, dose 2
MedDRA: Headache, Muscle spasms, Pain in extremity — Feeling: Fair

Free text: Headache 2am 3 days out of 7 days a week. Leg pain back of calf and upper thigh cramps every night both legs.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-18
Survey response — day 35, dose 2
MedDRA: Headache — Feeling: Good

Free text: Headache morning 3 times a week.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-13
Survey response — 3 months, dose 2
MedDRA: Fatigue, Headache, Insomnia, Muscle spasms — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headache s early in morning. Leg cramps, and very tried around 9:30-10:00 everyday. Can't sleep at night.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-12
Survey response — 6 months, dose 2
MedDRA: Eye inflammation, Muscle spasms, Pain in extremity — Feeling: Good

Free text: Leg cramps and pain at night. Eye inflammation that will not go away.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-22
Dose 3 — Moderna
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Back pain, Pain in extremity — Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Leg and back pain

MedDRA releases: 2024-11 · check-in free text available
2021-10-31
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-11-05
Survey response — day 14, dose 3
MedDRA: Pain in extremity — Feeling: Good

Free text: Leg pain

MedDRA releases: 2024-11 · check-in free text available
2021-11-12
Survey response — day 21, dose 3
MedDRA: Headache — Feeling: Good

Free text: Headache

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Survey response — day 28, dose 3
MedDRA: Headache — Feeling: Good

Free text: Headache each morning

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-21
Survey response — 3 months, dose 3
MedDRA: Muscle spasms, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Muscle soreness and cramps lower back and legs.

MedDRA releases: 2024-11 · check-in free text available
2022-04-24
Dose 4 — Moderna
2022-04-28
Survey response — 6 months, dose 3
MedDRA: Back pain, Bone pain, Cough, Fatigue, Oropharyngeal pain — Feeling: Good · Be unable to do your normal daily activities

Free text: 2nd boosters shot 24 April 2022. The 25th and 26th April was tried, dry coughing, sore throat and lower back hurting with bone pain. 26th - 28th feeling better like myself again.

MedDRA releases: 2024-11 · check-in free text available
2022-05-18
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-22
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-29
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-05
Survey response — day 42, dose 4
MedDRA: Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headache 3 days out the week mostly at night and early morning.

MedDRA releases: 2024-11 · check-in free text available
2022-07-24
Survey response — 3 months, dose 4
MedDRA: Abdominal distension — Feeling: Fair · Be unable to do your normal daily activities

Free text: Abdomen swelling

MedDRA releases: 2024-11 · check-in free text available
2022-10-23
Survey response — 6 months, dose 4
MedDRA: Fatigue, Pain — Feeling: Fair

Free text: Muscle soreness and tried

MedDRA releases: 2024-11 · check-in free text available
2023-04-24
Survey response — 12 months, dose 4
MedDRA: Myalgia, Physiotherapy — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-04-24
Report sent to call center — 12 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2023-04-25
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-14	Moderna
2	2021-02-11	Moderna
3	2021-10-22	Moderna	No
4	2022-04-24	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2023-04-24	Successful 2023-04-25	Does not wish to fill out VAERS report

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): None

Release 4 — days 1–6 daily, dose 2

2021-02-14

Systemic reaction (other): Right eye red and sensitive to light.

Release 5 — day 21, dose 2

2021-03-04

Symptoms: Headache 2am 3 days out of 7 days a week. Leg pain back of calf and upper thigh cramps every night both legs.

Release 5 — day 35, dose 2

2021-03-18

Symptoms: Headache morning 3 times a week.

Release 8 — 3 months, dose 2

2021-05-13

Symptoms: Headache s early in morning. Leg cramps, and very tried around 9:30-10:00 everyday. Can't sleep at night.

Release 9 — 6 months, dose 2

2021-08-12

Symptoms: Leg cramps and pain at night. Eye inflammation that will not go away.

Release 10 — days 1–6 daily, dose 3

2021-10-28

Systemic reaction (other): Leg and back pain

Release 10 — day 14, dose 3

2021-11-05

Symptoms: Leg pain

Release 10 — day 21, dose 3

2021-11-12

Symptoms: Headache

Release 10 — day 28, dose 3

2021-11-19

Symptoms: Headache each morning

Release 11 — 3 months, dose 3

2022-01-21

Symptoms: Muscle soreness and cramps lower back and legs.

Release 11 — 6 months, dose 3

2022-04-28

Symptoms: 2nd boosters shot 24 April 2022. The 25th and 26th April was tried, dry coughing, sore throat and lower back hurting with bone pain. 26th - 28th feeling better like myself again.

Release 11 — day 42, dose 4

2022-06-05

Symptoms: Headache 3 days out the week mostly at night and early morning.

Release 12 — 3 months, dose 4

2022-07-24

Symptoms: Abdomen swelling

Release 12 — 6 months, dose 4

2022-10-23

Symptoms: Muscle soreness and tried

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	Physiotherapy	·	·	✓
SD	Abdominal distension	·	·	✓
SD	Back pain	·	·	✓
SD	Bone pain	·	·	✓
SD	Cough	·	·	✓
SD	Eye inflammation	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Myalgia	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pain in extremity	✓	✓	✓
SRO	Back pain	·	·	✓
SRO	No adverse event	✓	✓	✓
SRO	Ocular hyperaemia	✓	✓	✓
SRO	Pain in extremity	·	·	✓
SRO	Photophobia	✓	✓	✓

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