ZVT-16495-53413

4 vaccinations 11 coded responses 33 check-ins 10 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 212 / MD
Registered: 2021-02-16

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

2021-01-28
Dose 1 — Moderna
2021-02-16
Registered in v-safe
2021-02-16
Survey response — day 14, dose 1
MedDRA: Fatigue, Feeling abnormal, Oropharyngeal pain — Feeling: Fair

Free text: Slight sore throat, fatigue... under the weather feeling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — day 21, dose 1
MedDRA: Cough, Malaise, Oropharyngeal pain — Feeling: Good

Free text: Sore throat, cough for one day, mild sick all over feeling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Dose 2 — Moderna
2021-02-25
Survey response — day 0, dose 2
MedDRA: Nasal congestion — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Slight stuffy nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains · Be unable to do your normal daily activities

Adult check-in
2021-03-04
Health check-in — day 7, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-25
Survey response — day 28, dose 2
MedDRA: Arthralgia, Neck pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Very achy joints... esp sore neck and shoulders ... but sore neck was left-died and I was vaccinated in the right arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-27
Survey response — 3 months, dose 2
MedDRA: Back pain, Sacral pain — 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: Back pain lower left... spine Or sacroiliac

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
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)
2021-08-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Dose 3 — Moderna
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-10-29
Survey response — day 7, dose 3
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-12
Survey response — day 21, dose 3
MedDRA: Back pain, Pre-existing disease — Feeling: Good

Free text: Reoccurrence of lower back pain

MedDRA releases: 2024-11 · check-in free text available
2021-11-21
Survey response — day 28, dose 3
MedDRA: Condition aggravated, Office visit, Pre-existing disease, Root canal infection — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Problems with an old root canal infected will have to have tooth extracted · Healthcare visit (other): Regular dental office visits

MedDRA releases: 2024-11 · check-in free text available
2021-11-21
Report sent to call center — day 28, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-23
Call 1 — Could Not Reach Participant
2021-11-23
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-11-29
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-30
Survey response — day 35, dose 3
MedDRA: Infection, Office visit, Tooth extraction, Tooth fracture — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Tooth extraction due to crack and low grade infection · Healthcare visit (other): Dentist by appointment

MedDRA releases: 2024-11 · check-in free text available
2021-11-30
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-13
Call 3 — Left Voicemail
2022-01-24
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-07
Dose 4 — Moderna
2022-04-18
Health check-in — day 7, dose 4
Feeling: Fair · Nausea, Diarrhea

Adult check-in
2022-04-24
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-28
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-07
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-14
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-21
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-10-06
Survey response — 6 months, dose 4
MedDRA: Arthritis, Asthma, COVID-19, Office visit, Physiotherapy, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Covid, asthma flare up, arthritis flare up back and neck · Healthcare visit (other): Regular office visits and physical therapy

MedDRA releases: 2024-11 · check-in free text available
2022-10-06
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-10-07
Call 2 — Left Voicemail
2022-10-07
Call 2 — Left Voicemail
2023-04-07
Survey response — 12 months, dose 4
MedDRA: Proctitis, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-04-07
Report sent to call center — 12 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-04-10
Call 1 — Left Voicemail
2023-04-10
Call 1 — Left Voicemail
2023-04-10
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-02-25	Moderna
3	2021-10-22	Moderna	No
4	2022-04-07	Moderna	No

Call center

5 call center cases

2 successful · 3 unsuccessful

See the call center timeline

Free text

Release 4 — day 14, dose 1

2021-02-16

Symptoms: Slight sore throat, fatigue... under the weather feeling

Release 4 — day 21, dose 1

2021-02-18

Symptoms: Sore throat, cough for one day, mild sick all over feeling

Release 4 — day 0, dose 2

2021-02-25

Systemic reaction (other): Slight stuffy nose

Release 6 — day 28, dose 2

2021-03-25

Symptoms: Very achy joints... esp sore neck and shoulders ... but sore neck was left-died and I was vaccinated in the right arm

Release 8 — 3 months, dose 2

2021-05-27

Symptoms: Back pain lower left... spine Or sacroiliac

Release 10 — day 7, dose 3

2021-10-29

Systemic reaction (other): No

Release 10 — day 21, dose 3

2021-11-12

Symptoms: Reoccurrence of lower back pain

Release 10 — day 28, dose 3

2021-11-21

Symptoms: Problems with an old root canal infected will have to have tooth extracted

Healthcare visit (other): Regular dental office visits

Release 10 — day 35, dose 3

2021-11-30

Symptoms: Tooth extraction due to crack and low grade infection

Healthcare visit (other): Dentist by appointment

Release 12 — 6 months, dose 4

2022-10-06

Symptoms: Covid, asthma flare up, arthritis flare up back and neck

Healthcare visit (other): Regular office visits and 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

Field	Preferred term	2021-09	2023-04	2024-11
HCVO	Office visit	·	·	✓
HCVO	Physiotherapy	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Arthritis	·	·	✓
SD	Asthma	·	·	✓
SD	Back pain	✓	✓	✓
SD	Condition aggravated	·	·	✓
SD	Cough	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Infection	·	·	✓
SD	Malaise	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Proctitis	·	·	✓
SD	Root canal infection	·	·	✓
SD	Sacral pain	✓	✓	✓
SD	Tooth extraction	·	·	✓
SD	Tooth fracture	·	·	✓
SD	Unevaluable event	·	·	✓
SRO	Nasal congestion	✓	✓	✓
SRO	No adverse event	·	·	✓

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