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
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2021-01-05
Dose 1 — Moderna
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2021-01-14
Registered in v-safe
- 2021-01-14
- 2021-01-21
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2021-01-26
Survey response — day 21, dose 1MedDRA: Arthralgia, Headache, Joint stiffness, Muscular weakness — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Slight intermittent headaches in top/right side of head, increased weakness of knees/pain, stiffnessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-26
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-02-01
Dose 2 — Moderna
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2021-02-02
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
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2021-02-03
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-02-04
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, NauseaAdult check-in
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2021-02-06
Survey response — days 1–6 daily, dose 2MedDRA: Adverse reaction — Feeling: Fair · Headache, Joint pains, Muscle or body achesFree 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
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2021-02-07
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness, Self-medication — Feeling: Poor · Headache, Muscle or body aches · Be unable to do your normal daily activitiesFree 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 reliefMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-09
- 2021-02-15
- 2021-02-22
- 2021-03-01
- 2021-03-08
- 2021-03-17
- 2021-04-08
- 2021-05-06
- 2021-08-05
- 2022-02-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-05 | Moderna | |
| 2 | 2021-02-01 | Moderna |
Call center
1 call center case
1 unsuccessful
Free text
Release 2 — day 21, dose 1
Symptoms: Slight intermittent headaches in top/right side of head, increased weakness of knees/pain, stiffness
Release 3 — days 1–6 daily, dose 2
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.
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Joint stiffness | ✓ | ✓ | ✓ |
| SD | Muscular weakness | ✓ | ✓ | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release