2R4-19133-50606
2 vaccinations
6 coded responses
20 check-ins
6 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 641 / MO
- Registered
- 2021-01-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-13
Dose 1 — Moderna
-
2021-01-17
Registered in v-safe
- 2021-01-17
-
2021-01-18
Survey response — days 1–6 daily, dose 1MedDRA: Adverse reaction — Feeling: Fair · Fever · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: My temp is usually 97.4-97.7 Been taking almost daily since this all started.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-18
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
- 2021-01-19
- 2021-01-22
- 2021-01-27
-
2021-02-03
Survey response — day 21, dose 1MedDRA: Arthralgia, Asthenia, Fatigue, Injection site joint pain — Feeling: FairFree text: Tiredness never went away. Getting worse. Joints achy especially sholder where injection was. If i get any weaker i wont be able to work.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-09
Dose 2 — Moderna
-
2021-02-10
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-02-11
Survey response — days 1–6 daily, dose 2MedDRA: Epistaxis — Feeling: Fair · Site: Pain, Swelling · 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: Nose bleed after a warm bathMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-12
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-02-13
- 2021-02-15
- 2021-02-16
-
2021-02-23
Survey response — day 14, dose 2MedDRA: Muscular weakness, Pain in extremity — Feeling: Good · Be unable to do your normal daily activitiesFree text: Nerve pain and weakness in left arm. Feel it down arm, past elbow and into hand between fingers. Never had this before.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-02
Survey response — day 21, dose 2MedDRA: Pain in extremity, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Pain in arm running down to hand · Healthcare visit (other): Have appt on FridayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-02
Report sent to call center — day 21, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-09
- 2021-03-16
- 2021-03-25
- 2021-05-14
-
2021-07-30
Call successfulDoes not wish to fill out VAERS report
- 2021-08-10
-
2022-02-09
Survey response — 12 months, dose 2MedDRA: Injection site pain, Tinnitus — Feeling: GoodFree text: 1. Pain in arm where vaccinated. 2. Really loud tinnitus since booster.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-13 | Moderna | |
| 2 | 2021-02-09 | Moderna |
Call center
2 call center cases
1 successful · 1 priority 2/3 (triaged and no follow up)
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): My temp is usually 97.4-97.7 Been taking almost daily since this all started.
Release 3 — day 21, dose 1
Symptoms: Tiredness never went away. Getting worse. Joints achy especially sholder where injection was. If i get any weaker i wont be able to work.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Nose bleed after a warm bath
Release 4 — day 14, dose 2
Symptoms: Nerve pain and weakness in left arm. Feel it down arm, past elbow and into hand between fingers. Never had this before.
Release 4 — day 21, dose 2
Release 11 — 12 months, dose 2
Symptoms: 1. Pain in arm where vaccinated. 2. Really loud tinnitus since booster.
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 | Arthralgia | ✓ | ✓ | ✓ |
| SD | Asthenia | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Injection site joint pain | ✓ | ✓ | ✓ |
| SD | Injection site pain | · | · | ✓ |
| SD | Muscular weakness | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Tinnitus | · | · | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Epistaxis | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release