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27Q-32538-23784

2 vaccinations 3 coded responses 17 check-ins 3 free-text entries 1 call case
Sex
Female
Age at first dose
51-55
ZIP prefix
750 / TX
Registered
2021-01-14
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino
Registered dependents
NB4-20223-07359 Child or adolescent in my care · Male · 2021-10-24

Timeline

  1. 2021-01-05
    Dose 1 — Moderna
  2. 2021-01-14
    Registered in v-safe
  3. 2021-01-14
    Health check-in — day 7, dose 1
    Feeling: Good · Site: Pain, Swelling · Joint pains
    Adult check-in
  4. 2021-01-21
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  5. 2021-01-26
    Survey response — day 21, dose 1
    MedDRA: Arthralgia, Headache, Joint stiffness, Muscular weakness — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Slight intermittent headaches in top/right side of head, increased weakness of knees/pain, stiffness
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-01-26
    Report sent to call center — day 21, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  7. 2021-02-01
    Dose 2 — Moderna
  8. 2021-02-02
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain
    Adult check-in
  9. 2021-02-03
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  10. 2021-02-04
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Nausea
    Adult check-in
  11. 2021-02-06
    Survey response — days 1–6 daily, dose 2
    MedDRA: Adverse reaction — Feeling: Fair · Headache, Joint pains, Muscle or body aches
    Free text: Burst Capillaries in right eye above and to the right of cornea 3 days post vaccine. However, no blurred vision, no itching, no discharge, no swelling, no discomfort. Talked to physicians who felt not related, but since this survey said "other health conditions" to report, am including this occurrence.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-02-07
    Survey response — days 1–6 daily, dose 2
    MedDRA: Dizziness, Self-medication — Feeling: Poor · Headache, Muscle or body aches · Be unable to do your normal daily activities
    Free text: Dizziness like a vertigo feeling for most of day. Took 800mg Motrin in morning, not very much relief, took 1000mg of Tylenol this evening too see if can get relief
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-02-09
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  14. 2021-02-15
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-02-22
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-03-01
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-03-08
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-03-17
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-04-08
  20. 2021-05-06
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-08-05
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  22. 2022-02-03
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-05Moderna
22021-02-01Moderna

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 2 — day 21, dose 1

2021-01-26

Symptoms: Slight intermittent headaches in top/right side of head, increased weakness of knees/pain, stiffness

Release 3 — days 1–6 daily, dose 2

2021-02-06

Systemic reaction (other): Burst Capillaries in right eye above and to the right of cornea 3 days post vaccine. However, no blurred vision, no itching, no discharge, no swelling, no discomfort. Talked to physicians who felt not related, but since this survey said "other health conditions" to report, am including this occurrence.

2021-02-07

Systemic reaction (other): Dizziness like a vertigo feeling for most of day. Took 800mg Motrin in morning, not very much relief, took 1000mg of Tylenol this evening too see if can get relief

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
SDArthralgia ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDJoint stiffness ✓ ✓ ✓
SDMuscular weakness ✓ ✓ ✓
SROAdverse reaction ✓ ✓ ✓
SRODizziness ✓ ✓ ✓
SROSelf-medication ✓ ✓ ✓

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