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ZBU-16239-37166

2 vaccinations 5 coded responses 24 check-ins 5 free-text entries 0 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
532 / WI
Registered
2021-02-07
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-05
    Dose 1 — Moderna
  2. 2021-02-07
    Registered in v-safe
  3. 2021-02-07
    Survey response — days 1–6 daily, dose 1
    MedDRA: Arthralgia — Feeling: Fair · Site: Pain · Joint pains · Be unable to do your normal daily activities
    Free text: Extreme pain in shoulder. Similar to pain when I had rotator cuff injury.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-02-08
    Survey response — days 1–6 daily, dose 1
    MedDRA: Arthralgia, Insomnia — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: Shoulder still has deep ache. Difficult sleeping last night.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-02-09
    Survey response — days 1–6 daily, dose 1
    MedDRA: Arthralgia — Feeling: Fair · Fatigue or tiredness
    Free text: Still experiencing pain in shoulder that makes sleeping difficult.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-10
    Survey response — days 1–6 daily, dose 1
    MedDRA: Product administered at inappropriate site, Shoulder injury related to vaccine administration — Feeling: Good · Muscle or body aches
    Free text: Turns out I'm suffering from SIRVA because my vaccine was injected into my shoulder vs deltoid. Getting better.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-02-11
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-02-12
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-02-19
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-02-26
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-03-05
    Dose 2 — Moderna
  12. 2021-03-05
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  13. 2021-03-06
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work
    Adult check-in
  14. 2021-03-07
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Fever · Joint pains, Fatigue or tiredness
    Adult check-in
  15. 2021-03-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-03-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-03-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-03-11
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-03-12
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-03-19
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-03-26
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-04-02
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-04-09
    Survey response — day 35, dose 2
    MedDRA: Condition aggravated, Fatigue, Lymphadenopathy, Pre-existing disease, Self-medication — Feeling: Good · Be unable to do your normal daily activities
    Free text: Return of exhaustion plus a swollen gland under arm where shot given. Realized I'd been having a mast cell flare and took extra antihistamines, which controlled it. cetirizine plus benedryl
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  24. 2021-04-16
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-06-04
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-09-03
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  27. 2022-03-05
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-05Moderna
22021-03-05Moderna

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-07

Systemic reaction (other): Extreme pain in shoulder. Similar to pain when I had rotator cuff injury.

2021-02-08

Systemic reaction (other): Shoulder still has deep ache. Difficult sleeping last night.

2021-02-09

Systemic reaction (other): Still experiencing pain in shoulder that makes sleeping difficult.

Release 4 — days 1–6 daily, dose 1

2021-02-10

Systemic reaction (other): Turns out I'm suffering from SIRVA because my vaccine was injected into my shoulder vs deltoid. Getting better.

Release 7 — day 35, dose 2

2021-04-09

Symptoms: Return of exhaustion plus a swollen gland under arm where shot given. Realized I'd been having a mast cell flare and took extra antihistamines, which controlled it. cetirizine plus benedryl

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

FieldPreferred term2021-092023-042024-11
SDCondition aggravated ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDLymphadenopathy ✓ ✓ ✓
SDPre-existing disease ✓ ✓ ✓
SDSelf-medication ✓ ✓ ✓
SROArthralgia ✓ ✓ ✓
SROInsomnia ✓ ✓ ✓
SROProduct administered at inappropriate site ✓ ✓ ✓
SROShoulder injury related to vaccine administration ✓ ✓ ✓

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

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