ZMR-27918-51439
4 vaccinations
5 coded responses
50 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 195 / PA
- Registered
- 2021-02-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-04
Registered in v-safe
-
2021-02-04
Dose 1 — Moderna
- 2021-02-04
-
2021-02-05
Survey response — days 1–6 daily, dose 1MedDRA: Vaccination site joint pain — Feeling: Fair · Site: Pain · Joint painsFree text: Joint pain in the shoulder of the arm where I received my vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-06
Survey response — days 1–6 daily, dose 1MedDRA: Injection site joint pain — Feeling: Good · Site: Pain · Joint pains · Be unable to do your normal daily activitiesFree text: My joint pain is located in my shoulder joint close to the injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-07
Survey response — days 1–6 daily, dose 1MedDRA: Arthralgia — Feeling: Good · Site: Pain · Joint painsFree text: Joint pain, right shoulder, closest to injection site. I believe injection was too high on arm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-18
- 2021-02-25
-
2021-03-04
Dose 2 — Moderna
- 2021-03-04
-
2021-03-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-04-01
- 2021-04-08
- 2021-04-15
- 2021-06-03
- 2021-09-02
-
2021-11-10
Dose 3 — Moderna
- 2021-11-11
- 2021-11-12
- 2021-11-13
- 2021-11-14
- 2021-11-15
- 2021-11-16
- 2021-11-17
- 2021-11-25
- 2021-12-01
- 2021-12-08
- 2021-12-15
- 2021-12-22
-
2022-02-09
Survey response — 3 months, dose 3MedDRA: Chills, Cough, Nasopharyngitis, Oropharyngeal pain, SARS-CoV-2 test negative, Sinus congestion — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Cold-like symptoms, chills, sinus congestion, sore throat, and severe coughing. Rapid and PCR tests for Covid were negative.MedDRA releases: 2024-11 · check-in free text available
-
2022-02-09
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-03-24
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-05-11
-
2022-10-28
Dose 4 — Moderna
- 2022-10-30
-
2022-10-31
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-11-02
- 2022-11-03
- 2022-11-04
- 2022-11-11
- 2022-11-18
-
2022-11-25
Survey response — day 28, dose 4MedDRA: SARS-CoV-2 test negative, Sinusitis — 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 visitFree text: Sinus infection. Two negative Covid tests.MedDRA releases: 2024-11 · check-in free text available
-
2022-11-25
Report sent to call center — day 28, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-11-28
- 2022-12-02
- 2023-01-27
- 2023-04-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-04 | Moderna | |
| 2 | 2021-03-04 | Moderna | |
| 3 | 2021-11-10 | Moderna | No |
| 4 | 2022-10-28 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-02-09 | Successful 2022-03-24 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
| 2022-11-25 | Unsuccessful |
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Joint pain in the shoulder of the arm where I received my vaccine.
Systemic reaction (other): My joint pain is located in my shoulder joint close to the injection site.
Systemic reaction (other): Joint pain, right shoulder, closest to injection site. I believe injection was too high on arm.
Release 11 — 3 months, dose 3
Symptoms: Cold-like symptoms, chills, sinus congestion, sore throat, and severe coughing. Rapid and PCR tests for Covid were negative.
Release 12 — day 28, dose 4
Symptoms: Sinus infection. Two negative Covid tests.
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 | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Injection site joint pain | ✓ | ✓ | ✓ |
| SRO | Vaccination site joint pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release