ZAT-30902-16649

2 vaccinations 10 coded responses 20 check-ins 10 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 851 / AZ
Registered: 2021-02-26

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

2021-02-26
Registered in v-safe
2021-02-26
Dose 1 — Moderna
2021-02-26
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-27
Survey response — days 1–6 daily, dose 1
MedDRA: Insomnia, Pain — Feeling: Poor · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Could not sleep because of constant pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Survey response — days 1–6 daily, dose 1
MedDRA: Mobility decreased — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Still cant raise arm above shoulder level

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain, Insomnia — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Constant deep pain under injection site. Could not sleep

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 1
MedDRA: Mobility decreased, Pain — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Only have a quarter range of movement. If I try to go past that it is still painful. Sleeping better but pain still wakes me up.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Pain in extremity — Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activities

Free text: Painful shoulder and arm will not move higher than shoulder

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Mobility decreased, Office visit, Pain in extremity — Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Mobility of arm still restricted and painful. · Healthcare visit (other): Primary care physician in office so he could examine my arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-05
Survey response — day 7, dose 1
MedDRA: Office visit — Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Went to PC and he put me on prednisone for frozen shoulder · Healthcare visit (other): Primary Care physician

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Report sent to call center — day 7, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-12
Survey response — day 14, dose 1
MedDRA: Arthralgia, Mobility decreased, Office visit — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Pain in my shoulder and loss of mobility in arm. · Healthcare visit (other): Primary Care

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-19
Survey response — day 21, dose 1
MedDRA: Arthralgia, Mobility decreased, Office visit, Physiotherapy — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Sore shoulder and have lost at least 85% mobility of arm. · Healthcare visit (other): Primary Care physician and physical therapy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Report sent to call center — day 21, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-26
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-03-29
Dose 2 — Moderna
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-05
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-26
Health check-in — day 28, dose 2
Feeling: Good

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

Adult check-in
2021-05-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-28
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-27
Survey response — 6 months, dose 2
MedDRA: Rotator cuff repair — Feeling: Poor · Be unable to do your normal daily activities

Free text: Surgery for torn rotator cuff

MedDRA releases: 2024-11 · check-in free text available
2022-02-18
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-26	Moderna
2	2021-03-29	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-03-04	Unsuccessful
2021-03-05	Unsuccessful
2021-03-12	Unsuccessful
2021-03-19	Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-27

Systemic reaction (other): Could not sleep because of constant pain

2021-02-28

Systemic reaction (other): Still cant raise arm above shoulder level

2021-03-01

Systemic reaction (other): Constant deep pain under injection site. Could not sleep

2021-03-02

Systemic reaction (other): Only have a quarter range of movement. If I try to go past that it is still painful. Sleeping better but pain still wakes me up.

2021-03-03

Systemic reaction (other): Painful shoulder and arm will not move higher than shoulder

Release 5 — days 1–6 daily, dose 1

2021-03-04

Systemic reaction (other): Mobility of arm still restricted and painful.

Healthcare visit (other): Primary care physician in office so he could examine my arm.

Release 5 — day 7, dose 1

2021-03-05

Systemic reaction (other): Went to PC and he put me on prednisone for frozen shoulder

Healthcare visit (other): Primary Care physician

Release 5 — day 14, dose 1

2021-03-12

Symptoms: Pain in my shoulder and loss of mobility in arm.

Healthcare visit (other): Primary Care

Release 5 — day 21, dose 1

2021-03-19

Symptoms: Sore shoulder and have lost at least 85% mobility of arm.

Healthcare visit (other): Primary Care physician and physical therapy.

Release 9 — 6 months, dose 2

2021-09-27

Symptoms: Surgery for torn rotator cuff

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	✓	✓	✓
HCVO	Physiotherapy	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Mobility decreased	✓	✓	✓
SD	Rotator cuff repair	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Mobility decreased	✓	✓	✓
SRO	Office visit	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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