Z93-19439-61900
1 vaccination
2 coded responses
10 check-ins
2 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 167 / PA
- Registered
- 2021-03-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-06
Dose 1 — Moderna
-
2021-03-10
Registered in v-safe
- 2021-03-10
- 2021-03-11
- 2021-03-12
- 2021-03-20
- 2021-03-27
- 2021-04-03
-
2021-04-10
Survey response — day 35, dose 1MedDRA: Arthralgia, Feeling hot, Office visit, Swelling — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Shoulder pain,had since December, but didn't relate to Co-vid. Now I am wondering due to info I am reading.Been to ortho x-ray and MRI done.Still no better.Both arms affected, done swelling and warmth.Appling ice like instructed, but no better. · Healthcare visit (other): In office visit x3MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-10
Report sent to call center — day 35, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-06-05
Survey response — 3 months, dose 1MedDRA: Arthralgia, COVID-19, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: I started having left shoulder pain 2 weeks after co-vid in Nov. and it has spread to my right shoulder. Hoping it will go away.I have had cortisone etc.Any advice?? · Healthcare visit (other): Office visit,x-ray and MRIMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-05
Report sent to call center — 3 months, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-24
- 2021-09-04
-
2022-01-05
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-03-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-06 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-04-10 | Successful | Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2021-06-05 | Successful 2022-01-05 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 7 — day 35, dose 1
Symptoms: Shoulder pain,had since December, but didn't relate to Co-vid. Now I am wondering due to info I am reading.Been to ortho x-ray and MRI done.Still no better.Both arms affected, done swelling and warmth.Appling ice like instructed, but no better.
Healthcare visit (other): In office visit x3
Release 8 — 3 months, dose 1
Symptoms: I started having left shoulder pain 2 weeks after co-vid in Nov. and it has spread to my right shoulder. Hoping it will go away.I have had cortisone etc.Any advice??
Healthcare visit (other): Office visit,x-ray and MRI
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 | Office visit | ✓ | ✓ | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | COVID-19 | ✓ | ✓ | ✓ |
| SD | Feeling hot | ✓ | ✓ | ✓ |
| SD | Swelling | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release