2J4-87379-20153
5 vaccinations
16 coded responses
57 check-ins
15 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 216 / MD
- Registered
- 2021-01-25
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-25
Registered in v-safe
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2021-01-25
Dose 1 — Moderna
- 2021-01-25
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2021-01-26
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain, Reaction to previous exposure to any vaccine — Feeling: Good · Site: Pain, Swelling, ItchingFree text: Pain at injection site was a little worse than I expected (more than the flu shot)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
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2021-02-08
Survey response — day 14, dose 1MedDRA: Pain in extremity, Rhinorrhoea — Feeling: FairFree text: Aches pains on left side arm and leg (3 out of 10 on a scale) and slight runny nose just today) not taking any medication...May be unrelated. Just FYI.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-26
Dose 2 — Moderna
- 2021-02-26
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2021-02-27
Survey response — days 1–6 daily, dose 2MedDRA: Rhinorrhoea — Feeling: Good · Site: Pain, SwellingFree text: Runny noseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-28
Survey response — days 1–6 daily, dose 2MedDRA: Pre-existing disease, Rash — Feeling: Good · Site: Pain, Redness, ItchingFree text: I have a skin cancer scar about 3 in from my shot; it happened with the last one too, it got red and itchy there. This one is doing the same thing. Just FYIMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-01
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-12
- 2021-03-21
- 2021-03-26
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2021-04-02
Survey response — day 35, dose 2MedDRA: Chest pain, Emergency care, Heart rate increased, Heart rate irregular — Feeling: Good · Be unable to work, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Had a irregular heartbeat-fast issue/chest pain. Was checked out in ER but they found nothing. Following up with a cardiologist on 2/8.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-02
Report sent to call center — day 35, dose 2Be unable to work · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-11
- 2021-05-28
- 2021-06-11
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2021-10-26
Dose 3 — Moderna
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2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: Pain, Reaction to previous exposure to any vaccine — Feeling: Fair · Site: Pain, Swelling · Chills, Muscle or body aches, Fatigue or tirednessFree text: This 3rd shot I did in the opposite arm; seems more painful than the other two-more symptoms than before on 1/2 the doseMedDRA releases: 2024-11 · check-in free text available
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2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-10-29
- 2021-10-30
- 2021-11-01
- 2021-11-04
- 2021-11-09
- 2021-11-16
- 2021-11-23
- 2021-12-02
- 2021-12-07
- 2022-01-27
- 2022-04-26
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2022-05-02
Dose 4 — Moderna
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2022-05-03
Survey response — days 1–6 daily, dose 4MedDRA: Flatulence — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: GasMedDRA releases: 2024-11 · check-in free text available
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2022-05-04
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
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2022-05-05
Survey response — days 1–6 daily, dose 4MedDRA: Injection site erythema, Injection site pruritus, Pre-existing disease — Feeling: Good · Site: Redness, Itching · Rash, not including the immediate area around the injection siteFree text: I have a skin cancer scar approximately 3 inches south from the injection site that is where the redness is from more pronounced over the last day and it itches there. Not so much a rash per se. This happened the last time I got a doseMedDRA releases: 2024-11 · check-in free text available
- 2022-05-08
- 2022-05-09
- 2022-05-16
- 2022-05-23
- 2022-05-30
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2022-06-06
Survey response — day 35, dose 4MedDRA: Oropharyngeal pain — Feeling: GoodFree text: Sore throatMedDRA releases: 2024-11 · check-in free text available
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2022-06-13
Survey response — day 42, dose 4MedDRA: Cough, Oropharyngeal pain, SARS-CoV-2 test positive — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Just a mildSore throat -dry cough. No fever, no loss of smell or taste so presuming it's Omnicron. Tested positive on 6/9 for Covid.MedDRA releases: 2024-11 · check-in free text available
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2022-06-13
Report sent to call center — day 42, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-06-14
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2022-06-16
Call successfulDoes not wish to fill out VAERS report
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2022-11-10
Dose 5 — Pfizer-BioNTech
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2022-11-11
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain, Redness · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2022-11-12
Survey response — days 1–6 daily, dose 5MedDRA: Injection site bruising — Feeling: Good · Site: Pain, Swelling · Headache, Joint pains, Muscle or body achesFree text: Bruising at injection siteMedDRA releases: 2024-11 · check-in free text available
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2022-11-13
Survey response — days 1–6 daily, dose 5MedDRA: Injection site bruising — Feeling: Good · Site: SwellingFree text: Bruising at the injection siteMedDRA releases: 2024-11 · check-in free text available
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2022-11-14
Survey response — days 1–6 daily, dose 5MedDRA: Injection site bruising — Feeling: Good · Site: RednessFree text: Bruise at injection siteMedDRA releases: 2024-11 · check-in free text available
- 2022-11-15
- 2022-11-16
- 2022-11-19
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2022-11-24
Survey response — day 14, dose 5MedDRA: Abdominal pain, Urinary tract pain — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Urinary tract pain. Sore abdominals.MedDRA releases: 2024-11 · check-in free text available
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2022-11-24
Report sent to call center — day 14, dose 5Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-11-25
Call successfulDoes not wish to fill out VAERS report
- 2022-12-01
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2022-12-08
Survey response — day 28, dose 5MedDRA: Pain in extremity, Paranasal sinus discomfort, Sinusitis, Upper-airway cough syndrome, Urinary tract infection — Feeling: Poor · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Urinary tract infection; antibiotics done now had some random arm pains in shot arm as well as sinusitis (not Covid) could be a basic cold-day of sore throat, day of sinus, 3rd day pressure-sinus post nasal dripsMedDRA releases: 2024-11 · check-in free text available
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2022-12-08
Report sent to call center — day 28, dose 5Be 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)
- 2022-12-09
- 2022-12-17
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2023-02-11
Survey response — 3 months, dose 5MedDRA: Arthralgia, Pain — Feeling: GoodMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-25 | Moderna | |
| 2 | 2021-02-26 | Moderna | |
| 3 | 2021-10-26 | Moderna | No |
| 4 | 2022-05-02 | Moderna | No |
| 5 | 2022-11-10 | Pfizer-BioNTech | No |
Call center
4 call center cases
3 successful · 1 unsuccessful
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Pain at injection site was a little worse than I expected (more than the flu shot)
Release 3 — day 14, dose 1
Symptoms: Aches pains on left side arm and leg (3 out of 10 on a scale) and slight runny nose just today) not taking any medication...May be unrelated. Just FYI.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Runny nose
Systemic reaction (other): I have a skin cancer scar about 3 in from my shot; it happened with the last one too, it got red and itchy there. This one is doing the same thing. Just FYI
Release 6 — day 35, dose 2
Symptoms: Had a irregular heartbeat-fast issue/chest pain. Was checked out in ER but they found nothing. Following up with a cardiologist on 2/8.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): This 3rd shot I did in the opposite arm; seems more painful than the other two-more symptoms than before on 1/2 the dose
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Gas
Systemic reaction (other): I have a skin cancer scar approximately 3 inches south from the injection site that is where the redness is from more pronounced over the last day and it itches there. Not so much a rash per se. This happened the last time I got a dose
Release 11 — day 35, dose 4
Symptoms: Sore throat
Release 12 — day 42, dose 4
Symptoms: Just a mildSore throat -dry cough. No fever, no loss of smell or taste so presuming it's Omnicron. Tested positive on 6/9 for Covid.
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Bruising at injection site
Systemic reaction (other): Bruising at the injection site
Systemic reaction (other): Bruise at injection site
Release 12 — day 14, dose 5
Symptoms: Urinary tract pain. Sore abdominals.
Release 12 — day 28, dose 5
Symptoms: Urinary tract infection; antibiotics done now had some random arm pains in shot arm as well as sinusitis (not Covid) could be a basic cold-day of sore throat, day of sinus, 3rd day pressure-sinus post nasal drips
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 | Abdominal pain | · | · | ✓ |
| SD | Arthralgia | · | · | ✓ |
| SD | Chest pain | ✓ | ✓ | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Emergency care | ✓ | ✓ | ✓ |
| SD | Heart rate increased | ✓ | ✓ | ✓ |
| SD | Heart rate irregular | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Paranasal sinus discomfort | · | · | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Upper-airway cough syndrome | · | · | ✓ |
| SD | Urinary tract infection | · | · | ✓ |
| SD | Urinary tract pain | · | · | ✓ |
| SRO | Flatulence | · | · | ✓ |
| SRO | Injection site bruising | · | · | ✓ |
| SRO | Injection site erythema | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site pruritus | · | · | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Reaction to previous exposure to any vaccine | ✓ | ✓ | ✓ |
| SRO | Rhinorrhoea | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release