ZA2-96688-04151

3 vaccinations 12 coded responses 37 check-ins 12 free-text entries 0 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 981 / WA
Registered: 2021-01-05

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-01-05
Registered in v-safe
2021-01-05
Dose 1 — Moderna
2021-01-05
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-01-07
Survey response — days 1–6 daily, dose 1
MedDRA: Pain — Feeling: Good · Site: Pain

Free text: Pain lifting my arm overhead, taking sports bra off, lying on L side but I am able to do but w/ pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Pain — Feeling: Good · Site: Pain

Free text: Still have painful shoulder range of motion, reaching out from the body and overhead reaching.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-09
Survey response — days 1–6 daily, dose 1
MedDRA: Musculoskeletal discomfort — Feeling: Good

Free text: Discomfort at very en range shoulder elevation.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Survey response — day 14, dose 1
MedDRA: Arthralgia, Injected limb mobility decreased — Feeling: Good

Free text: Increase Left shoulder pain and difficulty lifting my left arm away from my body. Symptoms improved day 5 but then returned and worsened on day 8-13. I have managed with 1800 mg Ibuprofen and ice.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Survey response — day 21, dose 1
MedDRA: Arthralgia — Feeling: Fair

Free text: Painful moving my shoulder and lifting arm overhead or put to the side.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Dose 2 — Moderna
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-31
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy, Neck pain — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches

Free text: Swelling in underarm and lump in lymph nodes. Some R lateral neck pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain, Redness, Itching

Free text: Swelling in axillary lymph node on injection side.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Survey response — days 1–6 daily, dose 2
MedDRA: Lymph node pain, Oedema peripheral — Feeling: Good · Site: Pain, Redness, Swelling, Itching

Free text: Lymph node tenderness and swelling in underarm on side injection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good · Site: Pain

Free text: R axillary lymph node tenderness/swelling.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-12
Survey response — day 42, dose 2
MedDRA: Headache — Feeling: Fair

Free text: Headache around Left ear.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-06
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-06
Dose 3 — Moderna
2021-11-06
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-08
Survey response — days 1–6 daily, dose 3
MedDRA: Oedema peripheral — Feeling: Good · Site: Pain

Free text: Swollen underarm pit on side injection

MedDRA releases: 2024-11 · check-in free text available
2021-11-10
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache

Adult check-in
2021-11-11
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache

Adult check-in
2021-11-12
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-13
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-20
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-27
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-04
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-20
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-07
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-09
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-06
Survey response — 12 months, dose 3
MedDRA: Nasopharyngitis — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I had a cold lasting 2 weeks. Tested negative 3 home tests and negative PCR.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-05	Moderna
2	2021-01-29	Moderna
3	2021-11-06	Moderna	No

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-07

Systemic reaction (other): Pain lifting my arm overhead, taking sports bra off, lying on L side but I am able to do but w/ pain.

2021-01-08

Systemic reaction (other): Still have painful shoulder range of motion, reaching out from the body and overhead reaching.

2021-01-09

Systemic reaction (other): Discomfort at very en range shoulder elevation.

Release 2 — day 14, dose 1

2021-01-19

Symptoms: Increase Left shoulder pain and difficulty lifting my left arm away from my body. Symptoms improved day 5 but then returned and worsened on day 8-13. I have managed with 1800 mg Ibuprofen and ice.

Release 2 — day 21, dose 1

2021-01-26

Symptoms: Painful moving my shoulder and lifting arm overhead or put to the side.

Release 3 — days 1–6 daily, dose 2

2021-01-31

Systemic reaction (other): Swelling in underarm and lump in lymph nodes. Some R lateral neck pain.

2021-02-01

Systemic reaction (other): Swelling in axillary lymph node on injection side.

2021-02-02

Systemic reaction (other): Lymph node tenderness and swelling in underarm on side injection.

2021-02-03

Systemic reaction (other): R axillary lymph node tenderness/swelling.

Release 5 — day 42, dose 2

2021-03-12

Symptoms: Headache around Left ear.

Release 10 — days 1–6 daily, dose 3

2021-11-08

Systemic reaction (other): Swollen underarm pit on side injection

Release 12 — 12 months, dose 3

2022-11-06

Symptoms: I had a cold lasting 2 weeks. Tested negative 3 home tests and negative PCR.

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
SD	Arthralgia	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injected limb mobility decreased	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Musculoskeletal discomfort	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Oedema peripheral	✓	✓	✓
SRO	Pain	✓	✓	✓

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