YU8-24289-75633

4 vaccinations 5 coded responses 40 check-ins 5 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 341 / FL
Registered: 2021-04-11

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

Timeline

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

2021-03-22
Dose 1 — Pfizer-BioNTech
2021-04-11
Registered in v-safe
2021-04-11
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-12
Dose 2 — Pfizer-BioNTech
2021-04-12
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Musculoskeletal discomfort, Pain — Feeling: Poor · Site: Pain · Muscle or body aches · Be unable to do your normal daily activities

Free text: Limited shoulder active range of motion due to pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Diarrhea

Adult check-in
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Tenderness — Feeling: Good · Muscle or body aches

Free text: Shoulder still tender to palpation.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Survey response — days 1–6 daily, dose 2
MedDRA: Tenderness — Feeling: Good

Free text: Shoulder still tender to palpate on.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-28
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-12
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-12
Survey response — 6 months, dose 2
MedDRA: Arthralgia, Injected limb mobility decreased, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Can no longer lift my left arm overhead with pain in the shoulder - is this a side affect of a Covid vaccine injection in the arm? Can A Covid vaccine injection in that shoulder have contributed to my current condition? · Healthcare visit (other): Appointment later this week as I have just returned from France.

MedDRA releases: 2024-11 · check-in free text available
2021-10-12
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-19
Call 1 — Could Not Reach Participant
2021-11-24
Call successful
Participant prefers to complete VAERS report online
2022-01-04
Dose 3 — Moderna
2022-01-05
Survey response — days 1–6 daily, dose 3
MedDRA: Decreased appetite — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: No appetite

MedDRA releases: 2024-11 · check-in free text available
2022-01-06
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · None · Be unable to do your normal daily activities

Adult check-in
2022-01-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · None

Adult check-in
2022-01-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · None

Adult check-in
2022-01-10
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · None

Adult check-in
2022-01-13
Health check-in — day 7, dose 3
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2022-01-18
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-27
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-02-01
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-02-10
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-15
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-04-05
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-10
Dose 4 — Moderna
2022-06-10
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain, Swelling · None

Adult check-in
2022-06-11
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-12
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-13
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-14
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-15
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Fatigue or tiredness

Adult check-in
2022-06-16
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Joint pains

Adult check-in
2022-06-17
Health check-in — day 7, dose 4
Feeling: Good · Joint pains

Adult check-in
2022-06-24
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-07-01
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-07-08
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-12-09
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-22	Pfizer-BioNTech
2	2021-04-12	Pfizer-BioNTech
3	2022-01-04	Moderna	No
4	2022-06-10	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-10-12	Successful 2021-11-24	Participant prefers to complete VAERS report online

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-13

Systemic reaction (other): Limited shoulder active range of motion due to pain.

2021-04-17

Systemic reaction (other): Shoulder still tender to palpation.

2021-04-18

Systemic reaction (other): Shoulder still tender to palpate on.

Release 10 — 6 months, dose 2

2021-10-12

Symptoms: Can no longer lift my left arm overhead with pain in the shoulder - is this a side affect of a Covid vaccine injection in the arm? Can A Covid vaccine injection in that shoulder have contributed to my current condition?

Healthcare visit (other): Appointment later this week as I have just returned from France.

Release 10 — days 1–6 daily, dose 3

2022-01-05

Systemic reaction (other): No appetite

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	Arthralgia	·	·	✓
SD	Injected limb mobility decreased	·	·	✓
SRO	Decreased appetite	·	·	✓
SRO	Musculoskeletal discomfort	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Tenderness	✓	✓	✓

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