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ZHC-33711-25971

4 vaccinations 11 coded responses 40 check-ins 11 free-text entries 4 call cases
Sex
Female
Age at first dose
61-65
ZIP prefix
088 / NJ
Registered
2021-01-04
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-04
    Registered in v-safe
  2. 2021-01-04
    Dose 1 — Moderna
  3. 2021-01-04
    Survey response — day 0, dose 1
    MedDRA: No adverse event — Feeling: Good · Headache
    Free text:
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-01-07
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Swelling, Itching · None
    Adult check-in
  5. 2021-01-08
    Survey response — days 1–6 daily, dose 1
    MedDRA: Nasal congestion, Throat clearing, Upper-airway cough syndrome, Wheezing — Feeling: Good · Site: Pain, Swelling, Itching
    Free text: Early morning about 12:20am had a clogged right nostril, Post nasal drip, Throat clearing and slight wheezing
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-01-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-01-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-01-11
    Health check-in — day 7, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  9. 2021-01-18
    Survey response — day 14, dose 1
    MedDRA: Headache, Self-medication — Feeling: Good
    Free text: Headache today, which is not normal for me. Took Advil.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-01-25
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-02-01
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-02-02
    Dose 2 — Moderna
  13. 2021-02-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Itching · None
    Adult check-in
  14. 2021-02-09
    Survey response — day 7, dose 2
    MedDRA: Fatigue, Headache, Myalgia, Pain in extremity, Pruritus, Self-medication — Feeling: Good · Site: Pain, Itching
    Free text: On the day after the 2nd dose I experienced moderate fatigue muscle aches and an intense headache. All symptoms were helped with Advil. I worked the next day from the bed but did not miss work all together. I did finish earlier than usual. The following day I had sore arm itching and another headache that started around 4pm. Slightly sore and itchy arm lasted for over a week.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-02-16
    Survey response — day 14, dose 2
    MedDRA: Arthralgia, Arthritis, Physiotherapy, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Worsening of Hip arthritis pain · Healthcare visit (other): Restarted Physical therapy and used Topical pain cream.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-02-16
    Report sent to call center — day 14, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  17. 2021-02-23
    Survey response — day 21, dose 2
    MedDRA: Arthralgia, Condition aggravated, Pre-existing disease — Feeling: Fair
    Free text: Increased hip pain more than usual
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-03-03
    Survey response — day 28, dose 2
    MedDRA: Arthritis, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Arthritis in hip has been worse since the 2nd vaccine.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  19. 2021-03-03
    Report sent to call center — day 28, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  20. 2021-03-09
    Health check-in — day 35, dose 2
    Feeling: Fair
    Adult check-in
  21. 2021-03-16
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-05-04
    Health check-in — 3 months, dose 2
    Feeling: Fair
    Adult check-in
  23. 2021-07-30
  24. 2021-08-03
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-10-26
    Dose 3 — Moderna
  26. 2021-10-26
    Health check-in — day 0, dose 3
    Feeling: Good · None
    Adult check-in
  27. 2021-10-27
    Survey response — days 1–6 daily, dose 3
    MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Sore throat
    MedDRA releases: 2024-11 · check-in free text available
  28. 2021-10-28
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain, Swelling, Itching · Headache
    Adult check-in
  29. 2021-10-29
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain, Swelling · None
    Adult check-in
  30. 2021-10-30
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  31. 2021-10-31
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  32. 2021-11-01
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  33. 2021-11-02
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  34. 2021-11-09
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  35. 2021-11-16
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  36. 2021-11-23
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  37. 2021-11-30
    Survey response — day 35, dose 3
    MedDRA: Arthralgia, Condition aggravated, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Hip bursitis flare up. Increased hip Pain.
    MedDRA releases: 2024-11 · check-in free text available
  38. 2021-12-07
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  39. 2022-01-25
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  40. 2022-04-26
    Survey response — 6 months, dose 3
    MedDRA: Adnexa uteri mass, Magnetic resonance imaging abnormal, Osteoarthritis, Unevaluable event — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: Diagnosed with osteoarthritis of left hip and Adnexal Mass during a recent MRI · Healthcare visit (other): MRI
    MedDRA releases: 2024-11 · check-in free text available
  41. 2022-04-26
    Report sent to call center — 6 months, dose 3
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  42. 2022-04-27
  43. 2022-06-07
    Dose 4 — Moderna
  44. 2022-06-28
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  45. 2022-07-05
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  46. 2022-07-12
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  47. 2022-07-19
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  48. 2022-09-06
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  49. 2022-12-06
    Survey response — 6 months, dose 4
    MedDRA: Arthralgia, Pain, Physiotherapy — Feeling: Good · 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: Symptoms: Shoulder pain. Rotator cuff pain. · Healthcare visit (other): Physical therapy
    MedDRA releases: 2024-11 · check-in free text available
  50. 2022-12-06
    Report sent to call center — 6 months, dose 4
    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)
  51. 2022-12-07
  52. 2022-12-07
  53. 2022-12-07
  54. 2022-12-07
  55. 2023-06-07
    Health check-in — 12 months, dose 4
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-04Moderna
22021-02-02Moderna
32021-10-26Moderna No
42022-06-07Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-02-16 Unsuccessful
2021-03-03 Unsuccessful
2022-04-26 Unsuccessful
2022-12-06 Unsuccessful

Free text

Release 1 — day 0, dose 1

2021-01-04

Release 1 — days 1–6 daily, dose 1

2021-01-08

Systemic reaction (other): Early morning about 12:20am had a clogged right nostril, Post nasal drip, Throat clearing and slight wheezing

Release 2 — day 14, dose 1

2021-01-18

Symptoms: Headache today, which is not normal for me. Took Advil.

Release 3 — day 7, dose 2

2021-02-09

Systemic reaction (other): On the day after the 2nd dose I experienced moderate fatigue muscle aches and an intense headache. All symptoms were helped with Advil. I worked the next day from the bed but did not miss work all together. I did finish earlier than usual. The following day I had sore arm itching and another headache that started around 4pm. Slightly sore and itchy arm lasted for over a week.

Release 4 — day 14, dose 2

2021-02-16

Symptoms: Worsening of Hip arthritis pain
Healthcare visit (other): Restarted Physical therapy and used Topical pain cream.

Release 4 — day 21, dose 2

2021-02-23

Symptoms: Increased hip pain more than usual

Release 4 — day 28, dose 2

2021-03-03

Symptoms: Arthritis in hip has been worse since the 2nd vaccine.

Release 10 — days 1–6 daily, dose 3

2021-10-27

Systemic reaction (other): Sore throat

Release 10 — day 35, dose 3

2021-11-30

Symptoms: Hip bursitis flare up. Increased hip Pain.

Release 11 — 6 months, dose 3

2022-04-26

Symptoms: Diagnosed with osteoarthritis of left hip and Adnexal Mass during a recent MRI
Healthcare visit (other): MRI

Release 12 — 6 months, dose 4

2022-12-06

Symptoms: Shoulder pain. Rotator cuff pain.
Healthcare visit (other): Physical therapy

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
HCVOOffice visit ○ ○ ○
HCVOPhysiotherapy ✓ ✓ ✓
HCVOUnevaluable event · · ✓
SDAdnexa uteri mass · · ✓
SDArthralgia ✓ ✓ ✓
SDArthritis ✓ ✓ ✓
SDCondition aggravated ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDMagnetic resonance imaging abnormal · · ✓
SDOsteoarthritis · · ✓
SDPain ○ ○ ✓
SDPre-existing disease ✓ ✓ ✓
SDSelf-medication ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SROMyalgia ✓ ✓ ✓
SRONasal congestion ✓ ✓ ✓
SRONo adverse event ✓ ✓ ✓
SROOropharyngeal pain · · ✓
SROPain in extremity ✓ ✓ ✓
SROPruritus ✓ ✓ ✓
SROSelf-medication ✓ ✓ ✓
SROThroat clearing ✓ ✓ ✓
SROUnevaluable event ○ ○ ○
SROUpper-airway cough syndrome ✓ ✓ ✓
SROWheezing ✓ ✓ ✓

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

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