YLT-18723-06804

4 vaccinations 11 coded responses 33 check-ins 11 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 212 / MD
Registered: 2021-01-13

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

2021-01-13
Registered in v-safe
2021-01-13
Dose 1 — Moderna
2021-01-13
Survey response — day 0, dose 1
MedDRA: General symptom, Pre-existing disease — Feeling: Good · Site: Pain · Joint pains

Free text: I have Rheumatoid Arthritis so I do not know if the symptoms are Moderna related.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Pain — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Free text: I am not certain if my prior Dx of Rheumatoid Arthritis is causing my pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Rheumatoid arthritis — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Free text: Rheumatoid Arthritis

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 · None

Adult check-in
2021-01-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Survey response — day 14, dose 1
MedDRA: Epistaxis, Musculoskeletal stiffness, Respiratory tract congestion — Feeling: Good

Free text: Nosebleed, congestion and stuffiness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-09
Dose 2 — Moderna
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Fair · Joint pains

Free text: Lower back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Cough — Feeling: Fair · Joint pains, Muscle or body aches

Free text: Lower back pain, cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Fair · Joint pains

Free text: Lower back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Back pain, Medical counselling — Feeling: Fair · Joint pains · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): Lower back and hip pain · Healthcare visit (other): X-rays

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-16
Survey response — day 7, dose 2
MedDRA: Arthralgia, Back pain, Pre-existing disease, Unevaluable event — Feeling: Poor · Joint pains, Muscle or body aches · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): Back pain, hip pain (chronic rheumatoid arthritis) · Healthcare visit (other): X-rays are fine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Report sent to call center — day 7, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-25
Survey response — day 14, dose 2
MedDRA: Arthralgia, Muscle spasms, Musculoskeletal pain, Pain in extremity — Feeling: Poor · Be unable to work

Free text: Muscle spasms and pain in buttocks, hip and left leg.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — day 21, dose 2
MedDRA: Muscle spasms — Feeling: Poor · Be unable to work

Free text: Muscle spams

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

Adult check-in
2021-03-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-02
Call 1 — Left Voicemail
2021-08-10
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-11
Dose 3 — Moderna
2022-02-09
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-02-10
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-23
Dose 4 — Moderna
Co-administered: Tetanus
2022-05-12
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-19
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-21
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-28
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-04
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-23
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-22
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-24
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Moderna
2	2021-02-09	Moderna
3	2021-11-11	Moderna	No
4	2022-04-23	Moderna	Tetanus

Call center

Reported	Outcome	VAERS-related outcome
2021-02-15	Unsuccessful
2021-02-16	Unsuccessful

Free text

Release 1 — day 0, dose 1

2021-01-13

Systemic reaction (other): I have Rheumatoid Arthritis so I do not know if the symptoms are Moderna related.

Release 2 — days 1–6 daily, dose 1

2021-01-14

Systemic reaction (other): I am not certain if my prior Dx of Rheumatoid Arthritis is causing my pain.

2021-01-15

Systemic reaction (other): Rheumatoid Arthritis

Release 2 — day 14, dose 1

2021-01-28

Symptoms: Nosebleed, congestion and stuffiness

Release 4 — days 1–6 daily, dose 2

2021-02-12

Systemic reaction (other): Lower back pain

2021-02-13

Systemic reaction (other): Lower back pain, cough

2021-02-14

Systemic reaction (other): Lower back pain

2021-02-15

Systemic reaction (other): Lower back and hip pain

Healthcare visit (other): X-rays

Release 4 — day 7, dose 2

2021-02-16

Systemic reaction (other): Back pain, hip pain (chronic rheumatoid arthritis)

Healthcare visit (other): X-rays are fine

Release 4 — day 14, dose 2

2021-02-25

Symptoms: Muscle spasms and pain in buttocks, hip and left leg.

Release 4 — day 21, dose 2

2021-03-02

Symptoms: Muscle spams

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	Medical counselling	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Epistaxis	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Musculoskeletal pain	✓	✓	✓
SD	Musculoskeletal stiffness	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	General symptom	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Rheumatoid arthritis	✓	✓	✓

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