2H5-20401-64449
5 vaccinations
23 coded responses
50 check-ins
21 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 546 / WI
- Registered
- 2021-02-25
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-02-25
Registered in v-safe
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2021-02-25
Dose 1 — Moderna
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2021-02-25
Survey response — day 0, dose 1MedDRA: Immediate post-injection reaction, Vaccination site pain — Feeling: Good · Site: PainFree text: The vaccine site hurt for about 10 minutes afterwardsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-26
Survey response — days 1–6 daily, dose 1MedDRA: Fatigue — Feeling: Good · Site: PainFree text: Fatigue last evening after I filled out this formMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-27
Survey response — days 1–6 daily, dose 1MedDRA: Condition aggravated, Pre-existing disease — Feeling: GoodFree text: Seem to be a little congested, have allergies, not sure if related. The day is considerably warmer, might be affecting allergies.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-28
- 2021-03-01
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2021-03-02
Survey response — days 1–6 daily, dose 1MedDRA: Adverse reaction — Feeling: GoodFree text: I received Reclast for osteoporosis this afternoon. I might have symptoms related to that this evening and tomorrow.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-03
Survey response — days 1–6 daily, dose 1MedDRA: Infusion — Feeling: Poor · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: I received Reclast yesterday afternoon and was told I may not feel well for 24-48 hours after the infusion.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-04
Survey response — day 7, dose 1MedDRA: Pain in extremity, Tendon pain — Feeling: GoodFree text: Right hand below the little finger, the soft tissue/tendons below were painful this morning, put the pain has decreased throughout the day. I did receive Reclast on Tuesday, March 2nd.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-11
- 2021-03-18
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2021-03-24
Dose 2 — Moderna
- 2021-03-24
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2021-03-25
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Feeling cold, Feeling hot — Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Felt chilled/cold most of the day, but did not register a fever, but felt like I had one. Had to take two naps just to function.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-26
Survey response — days 1–6 daily, dose 2MedDRA: Ocular discomfort, Oedema peripheral, Somnolence — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Had some pressure behind my eyes this morning, went away by afternoon. Do have some swelling in my left arm pit. The nodes are not enlarged. Was more tried today. Took a nap.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-27
- 2021-03-28
- 2021-03-29
- 2021-03-30
- 2021-03-31
- 2021-04-07
- 2021-04-14
- 2021-04-21
- 2021-04-28
- 2021-05-05
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2021-06-23
Survey response — 3 months, dose 2MedDRA: Ear discomfort, Pre-existing disease, Self-medication — Feeling: GoodFree text: Plugged ears. Needing to take Sudafed. I do have allergies. I was in a moldy building and started having symptoms shortly after.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-09-22
Survey response — 6 months, dose 2MedDRA: Pre-existing disease — Feeling: GoodFree text: Asthma, late summer, early fall symptoms are worse for meMedDRA releases: 2024-11 · check-in free text available
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2021-10-28
Dose 3 — Moderna
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2021-11-19
Survey response — day 21, dose 3MedDRA: Oedema peripheral, Palpitations — Feeling: GoodFree text: I have been having more heart palpitations recently. I will be seeing my primary MD late Nov and will discuss this. Had significant axillary swelling In vaccinated arm that lasted over a week. Has subsided now.MedDRA releases: 2024-11 · check-in free text available
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2021-11-25
Survey response — day 28, dose 3MedDRA: Initial insomnia, Palpitations, Sleep disorder — Feeling: GoodFree text: Continue to have intermittent palpitations. Sometimes it makes it difficult to fall asleep because they wake me upMedDRA releases: 2024-11 · check-in free text available
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2021-12-02
Survey response — day 35, dose 3MedDRA: Palpitations, Pre-existing disease, Productive cough — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Slight increase in productive cough. Have had a cough since September 2019 when I contracted an upper respiratory virus , not COVD . I have had the productive cough since then. Had increase in palpitations, but seem to have subsided now.MedDRA releases: 2024-11 · check-in free text available
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2021-12-02
Report sent to call center — day 35, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2021-12-07
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2021-12-07
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-12-09
- 2022-01-27
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2022-04-28
Survey response — 6 months, dose 3MedDRA: Serum ferritin decreased, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: I had donated blood in January, Ferritin went down to 24. Had a colonoscopy today. Everything looks good. · Healthcare visit (other): ColonoscopyMedDRA releases: 2024-11 · check-in free text available
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2022-04-28
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2022-04-29
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2022-05-10
Dose 4 — Moderna
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2022-05-17
Survey response — day 7, dose 4MedDRA: Exposure to SARS-CoV-2, Malaise, SARS-CoV-2 test positive — Feeling: Poor · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: I received my 4th Moderna on May 10th, my husband was positive for COVID on May 13th and I am positive for COVID as of May16th with symptoms. I started Paxlovid today. I am taken one dose so far.MedDRA releases: 2024-11 · check-in free text available
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2022-05-24
Survey response — day 14, dose 4MedDRA: COVID-19, Cough, Pre-existing disease — Feeling: GoodFree text: Since COVID (May 16th) and vaccine ( May 10th) I have had increase cough, although I had a cough before both. I did receive Paxlovid on May 17th for 5 daysMedDRA releases: 2024-11 · check-in free text available
- 2022-05-31
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2022-06-07
Survey response — day 28, dose 4MedDRA: Dyspnoea, Lung disorder, Respiratory disorder — Feeling: GoodFree text: I still have a little bit of breathing/lung issues. Takes more to get a deep breathMedDRA releases: 2024-11 · check-in free text available
- 2022-06-14
- 2022-06-21
- 2022-08-09
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2022-10-28
Dose 5 — ModernaCo-administered: Flu
- 2022-10-31
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2022-11-01
Survey response — days 1–6 daily, dose 5MedDRA: Oedema peripheral — Feeling: Good · Site: SwellingFree text: The swelling is under the left arm, not at the injection siteMedDRA releases: 2024-11 · check-in free text available
- 2022-11-02
- 2022-11-03
- 2022-11-04
- 2022-11-11
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2022-11-18
Survey response — day 21, dose 5MedDRA: Fatigue, Nasopharyngitis, Respiratory tract congestion — Feeling: FairFree text: Have a cold, congested and some fatigueMedDRA releases: 2024-11 · check-in free text available
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2022-11-25
Survey response — day 28, dose 5MedDRA: Respiratory tract congestion, Somnolence — Feeling: FairFree text: Have been congested for several days and needing to take a napMedDRA releases: 2024-11 · check-in free text available
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2022-12-02
Survey response — day 35, dose 5MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: FairFree text: Continue to have a bad cold, antigen COVID was negativeMedDRA releases: 2024-11 · check-in free text available
- 2022-12-09
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2023-01-29
Survey response — 3 months, dose 5MedDRA: Cough, Fatigue, Malaise, Productive cough, Pyrexia, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
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2023-04-28
Survey response — 6 months, dose 5MedDRA: Chest discomfort, Chills, Dyspnoea, Emergency care, Fatigue, Increased viscosity of upper respiratory secretion, Malaise, Productive cough, Pyrexia, Sputum discoloured — Feeling: Fair · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-25 | Moderna | |
| 2 | 2021-03-24 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
| 4 | 2022-05-10 | Moderna | No |
| 5 | 2022-10-28 | Moderna | Flu |
Call center
2 call center cases
1 successful · 1 unsuccessful
Free text
Release 4 — day 0, dose 1
Systemic reaction (other): The vaccine site hurt for about 10 minutes afterwards
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Fatigue last evening after I filled out this form
Systemic reaction (other): Seem to be a little congested, have allergies, not sure if related. The day is considerably warmer, might be affecting allergies.
Systemic reaction (other): I received Reclast for osteoporosis this afternoon. I might have symptoms related to that this evening and tomorrow.
Systemic reaction (other): I received Reclast yesterday afternoon and was told I may not feel well for 24-48 hours after the infusion.
Release 5 — day 7, dose 1
Systemic reaction (other): Right hand below the little finger, the soft tissue/tendons below were painful this morning, put the pain has decreased throughout the day. I did receive Reclast on Tuesday, March 2nd.
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Felt chilled/cold most of the day, but did not register a fever, but felt like I had one. Had to take two naps just to function.
Systemic reaction (other): Had some pressure behind my eyes this morning, went away by afternoon. Do have some swelling in my left arm pit. The nodes are not enlarged. Was more tried today. Took a nap.
Release 9 — 3 months, dose 2
Symptoms: Plugged ears. Needing to take Sudafed. I do have allergies. I was in a moldy building and started having symptoms shortly after.
Release 9 — 6 months, dose 2
Symptoms: Asthma, late summer, early fall symptoms are worse for me
Release 10 — day 21, dose 3
Symptoms: I have been having more heart palpitations recently. I will be seeing my primary MD late Nov and will discuss this. Had significant axillary swelling In vaccinated arm that lasted over a week. Has subsided now.
Release 10 — day 28, dose 3
Symptoms: Continue to have intermittent palpitations. Sometimes it makes it difficult to fall asleep because they wake me up
Release 10 — day 35, dose 3
Symptoms: Slight increase in productive cough. Have had a cough since September 2019 when I contracted an upper respiratory virus , not COVD . I have had the productive cough since then. Had increase in palpitations, but seem to have subsided now.
Release 11 — 6 months, dose 3
Symptoms: I had donated blood in January, Ferritin went down to 24. Had a colonoscopy today. Everything looks good.
Healthcare visit (other): Colonoscopy
Release 11 — day 7, dose 4
Systemic reaction (other): I received my 4th Moderna on May 10th, my husband was positive for COVID on May 13th and I am positive for COVID as of May16th with symptoms. I started Paxlovid today. I am taken one dose so far.
Release 11 — day 14, dose 4
Symptoms: Since COVID (May 16th) and vaccine ( May 10th) I have had increase cough, although I had a cough before both. I did receive Paxlovid on May 17th for 5 days
Release 11 — day 28, dose 4
Symptoms: I still have a little bit of breathing/lung issues. Takes more to get a deep breath
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): The swelling is under the left arm, not at the injection site
Release 12 — day 21, dose 5
Symptoms: Have a cold, congested and some fatigue
Release 12 — day 28, dose 5
Symptoms: Have been congested for several days and needing to take a nap
Release 12 — day 35, dose 5
Symptoms: Continue to have a bad cold, antigen COVID was negative
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 | Chest discomfort | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Ear discomfort | ✓ | ✓ | ✓ |
| SD | Emergency care | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Increased viscosity of upper respiratory secretion | · | · | ✓ |
| SD | Initial insomnia | · | · | ✓ |
| SD | Lung disorder | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oedema peripheral | · | · | ✓ |
| SD | Palpitations | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Productive cough | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory disorder | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Self-medication | ✓ | ✓ | ✓ |
| SD | Serum ferritin decreased | · | · | ✓ |
| SD | Sleep disorder | · | · | ✓ |
| SD | Somnolence | · | · | ✓ |
| SD | Sputum discoloured | · | · | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Condition aggravated | ✓ | ✓ | ✓ |
| SRO | Exposure to SARS-CoV-2 | · | · | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Feeling cold | ✓ | ✓ | ✓ |
| SRO | Feeling hot | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Infusion | ✓ | ✓ | ✓ |
| SRO | Malaise | · | · | ✓ |
| SRO | Ocular discomfort | ✓ | ✓ | ✓ |
| SRO | Oedema peripheral | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Somnolence | ✓ | ✓ | ✓ |
| SRO | Tendon pain | ✓ | ✓ | ✓ |
| SRO | Vaccination site pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release