2AJ-99447-66431
1 vaccination
5 coded responses
11 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 972 / OR
- Registered
- 2021-02-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
BJ3-81630-28614
Other · Female · 2021-10-24
Timeline
-
2021-02-09
Registered in v-safe
-
2021-02-09
Dose 1 — Moderna
-
2021-02-09
Survey response — day 0, dose 1MedDRA: Arthralgia, Chills, Myalgia, Pain in extremity — Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body achesFree text: felt good but 4hrs after injection, arm started hurting...10hrs later pain 5/10 & Chills, muscle&joint painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-10
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: this is actually my 2nd Moderna shot, wasnt able to correct it in the appMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-11
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tirednessAdult check-in
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-23
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2021-03-02
Survey response — day 21, dose 1MedDRA: Back pain, Pre-existing disease — Feeling: GoodFree text: Back ache but don't believe it is related...I get this upon occasion even before the vaccine. Usually strain of muscles or urinary tract infection. Not debilitating or new to me.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-08-10
Survey response — 6 months, dose 1MedDRA: Headache, Rhinorrhoea, SARS-CoV-2 test negative, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Headache, runny nose for a couple days ladt month. Got a covid19 test thru Kaiser Permanente - not detected. · Healthcare visit (other): Approval for Covid19 testMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-10
Report sent to call center — 6 months, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-12-01
- 2021-12-06
-
2022-02-09
Survey response — 12 months, dose 1MedDRA: Urinary tract infection — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: UtiMedDRA releases: 2024-11 · check-in free text available
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2022-02-09
Report sent to call center — 12 months, dose 1Be unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-02-11
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-09 | Moderna |
Call center
2 call center cases
2 successful
1 wait over 3 months for a first call
Free text
Release 3 — day 0, dose 1
Systemic reaction (other): felt good but 4hrs after injection, arm started hurting...10hrs later pain 5/10 & Chills, muscle&joint pain
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): this is actually my 2nd Moderna shot, wasnt able to correct it in the app
Release 4 — day 21, dose 1
Symptoms: Back ache but don't believe it is related...I get this upon occasion even before the vaccine. Usually strain of muscles or urinary tract infection. Not debilitating or new to me.
Release 9 — 6 months, dose 1
Symptoms: Headache, runny nose for a couple days ladt month. Got a covid19 test thru Kaiser Permanente - not detected.
Healthcare visit (other): Approval for Covid19 test
Release 11 — 12 months, dose 1
Symptoms: Uti
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 | Unevaluable event | ✓ | · | ✓ |
| SD | Back pain | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | ✓ | · | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | · | ✓ |
| SD | Urinary tract infection | · | · | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release