ZGU-45633-68773

5 vaccinations 10 coded responses 43 check-ins 8 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 017 / MA
Registered: 2021-03-16

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

2021-03-15
Dose 1 — Moderna
2021-03-16
Registered in v-safe
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-30
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 21, dose 1
Feeling: Good

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

Adult check-in
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Hyperhidrosis, Tremor — Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Weakness, trembling, sweating

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal, Pyrexia — Feeling: Fair · Site: Pain

Free text: Sorry I missed yesterday: I was still feverish and miserable, but today is much better

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-19
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-26
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
Survey response — day 28, dose 2
MedDRA: Cough — Feeling: Fair

Free text: I started coughing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-24
Survey response — day 42, dose 2
MedDRA: Rash — Feeling: Good

Free text: I have gotten a spreading rash, that might be poison ivy but has not been acting like poison ivy in that it spreads for several days although my clothing and bedding has been washed.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-12
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Nerve compression — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: My right hip has begun hurting like a nerve is being pinched in the hip socket. It has been going on for weeks.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-12
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-22
Call 1 — Left Voicemail
2021-10-11
Survey response — 6 months, dose 2
MedDRA: Appendicectomy, Appendicitis, Arthralgia, Mobility decreased, Pain, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: I had an appendectomy for acute appendicitis on August 13th. I am having continuing pain and difficulty with movement in my right hip. It's similar to an arthritis flare-up that won't go away.

MedDRA releases: 2024-11 · check-in free text available
2021-10-11
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

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-10-12
Call successful
Does not wish to fill out VAERS report
2021-10-21
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-11-16
Dose 3 — Moderna
2022-04-12
Survey response — 12 months, dose 2
MedDRA: Appendicectomy, Arthropathy, Epidermoid cyst excision — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: I had appendicitis surgery, also surgery to remove a dermoid cyst, and I have had roving problems with my joints: particularly my neck and right hip, my back, my shoulder, and my thumb.

MedDRA releases: 2024-11 · check-in free text available
2022-04-12
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-04-13
Call successful
Does not wish to fill out VAERS report
2022-05-03
Dose 4 — Pfizer-BioNTech
2022-05-03
Health check-in — day 0, dose 4
Feeling: Fair · Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2022-05-05
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Joint pains, Muscle or body aches, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-05-06
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Joint pains · Be unable to do your normal daily activities

Adult check-in
2022-05-07
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Joint pains · Be unable to do your normal daily activities

Adult check-in
2022-05-08
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Joint pains · Be unable to do your normal daily activities

Adult check-in
2022-05-11
Health check-in — day 7, dose 4
Feeling: Fair · Joint pains, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-05-19
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-05-24
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-05-31
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-06-07
Survey response — day 35, dose 4
MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Joint pain in hip and knees

MedDRA releases: 2024-11 · check-in free text available
2022-06-14
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-08-02
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-10-15
Dose 5 — Moderna
2022-10-24
Health check-in — day 7, dose 5
Feeling: Fair · Joint pains · Be unable to do your normal daily activities

Adult check-in
2022-10-30
Health check-in — day 14, dose 5
Feeling: Fair

Adult check-in
2022-11-06
Health check-in — day 21, dose 5
Feeling: Fair

Adult check-in
2022-11-13
Health check-in — day 28, dose 5
Feeling: Fair

Adult check-in
2022-11-21
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2022-11-27
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2023-01-16
Survey response — 3 months, dose 5
MedDRA: COVID-19, Nasopharyngitis — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-04-17
Survey response — 6 months, dose 5
MedDRA: Alopecia, Condition aggravated, Hormone replacement therapy, Office visit, Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-04-17
Report sent to call center — 6 months, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-04-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-15	Moderna
2	2021-04-12	Moderna
3	2021-11-16	Moderna	No
4	2022-05-03	Pfizer-BioNTech	No
5	2022-10-15	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-07-12	Successful 2021-10-21	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-10-11	Successful 2021-10-12	Does not wish to fill out VAERS report
2022-04-12	Successful 2022-04-13	Does not wish to fill out VAERS report
2023-04-17	Successful 2023-04-18	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-13

Systemic reaction (other): Weakness, trembling, sweating

2021-04-14

Systemic reaction (other): Sorry I missed yesterday: I was still feverish and miserable, but today is much better

Release 8 — day 28, dose 2

2021-05-10

Symptoms: I started coughing.

Release 8 — day 42, dose 2

2021-05-24

Symptoms: I have gotten a spreading rash, that might be poison ivy but has not been acting like poison ivy in that it spreads for several days although my clothing and bedding has been washed.

Release 9 — 3 months, dose 2

2021-07-12

Symptoms: My right hip has begun hurting like a nerve is being pinched in the hip socket. It has been going on for weeks.

Release 10 — 6 months, dose 2

2021-10-11

Symptoms: I had an appendectomy for acute appendicitis on August 13th. I am having continuing pain and difficulty with movement in my right hip. It's similar to an arthritis flare-up that won't go away.

Release 11 — 12 months, dose 2

2022-04-12

Symptoms: I had appendicitis surgery, also surgery to remove a dermoid cyst, and I have had roving problems with my joints: particularly my neck and right hip, my back, my shoulder, and my thumb.

Release 11 — day 35, dose 4

2022-06-07

Symptoms: Joint pain in hip and knees

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	Alopecia	·	·	✓
SD	Appendicectomy	·	·	✓
SD	Appendicitis	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Arthropathy	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Cough	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Epidermoid cyst excision	·	·	✓
SD	Hormone replacement therapy	·	·	✓
SD	Mobility decreased	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Nerve compression	✓	✓	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Rash	✓	✓	✓
SD	Unevaluable event	·	·	✓
SRO	Asthenia	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Tremor	✓	✓	✓

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