34A-17805-89656
5 vaccinations
12 coded responses
57 check-ins
11 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 921 / CA
- Registered
- 2021-01-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-01-27
Dose 1 — Moderna
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2021-01-28
Registered in v-safe
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2021-01-28
Survey response — days 1–6 daily, dose 1MedDRA: Dyspepsia — Feeling: Good · Site: PainFree text: Minor indigestionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-29
- 2021-01-30
- 2021-01-31
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2021-02-01
Survey response — days 1–6 daily, dose 1MedDRA: Parosmia — Feeling: Good · Site: Pain · ChillsFree text: Unusual odor from orificesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-02
- 2021-02-03
- 2021-02-10
- 2021-02-17
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2021-02-24
Dose 2 — Moderna
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2021-02-24
Survey response — day 0, dose 2MedDRA: Intranasal hypoaesthesia, Pain in jaw — Feeling: Good · Site: Pain, RednessFree text: Brief numbness of right nostril and minor transient right jaw painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-25
Survey response — days 1–6 daily, dose 2MedDRA: Hypoaesthesia — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, DiarrheaFree text: Right nostril feels numbMedDRA 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 2MedDRA: Contusion, Erythema, Hypoaesthesia — Feeling: Good · Site: PainFree text: Right nostril numbness fading but now bruising and redness appeared on numb site.MedDRA 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 2MedDRA: Contusion, Erythema, Hypoaesthesia — Feeling: Good · Site: Pain, Redness, Swelling · NauseaFree text: Bruising/redness on right nostril and adjacent cheek in areas that went numbMedDRA 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: Contusion — Feeling: Good · Site: Redness, Swelling, Itching · DiarrheaFree text: Nostril bruising continuesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-01
Survey response — days 1–6 daily, dose 2MedDRA: Contusion, Hypoaesthesia — Feeling: Good · Site: Redness, Itching · Joint painsFree text: Bruise on right nostril where it was numb after shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-02
Survey response — days 1–6 daily, dose 2MedDRA: Contusion, Hypoaesthesia — Feeling: Good · Site: Redness · Joint pains, Fatigue or tirednessFree text: Nose bruise continues on site of original numbnessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-03
Survey response — day 7, dose 2MedDRA: Contusion, Hypoaesthesia — Feeling: Good · Site: Pain · Joint painsFree text: Bruise on nostril where numbness arose right after vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-10
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2021-03-17
Survey response — day 21, dose 2MedDRA: Arthralgia, Fatigue, Headache — Feeling: FairFree text: Headache, fatigue, joint achesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
- 2021-03-31
- 2021-04-07
- 2021-05-26
- 2021-08-25
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2021-10-24
Dose 3 — Moderna
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2021-10-25
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Redness · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, DiarrheaAdult check-in
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2021-10-26
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Redness · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Redness · Joint pains, Muscle or body achesAdult check-in
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2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Redness, Swelling, Itching · Joint painsAdult check-in
- 2021-10-29
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2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Redness, Itching · NoneAdult check-in
- 2021-10-31
- 2021-11-07
- 2021-11-14
- 2021-11-21
- 2021-11-28
- 2021-12-05
- 2022-01-23
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2022-04-20
Dose 4 — Moderna
- 2022-04-20
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2022-04-21
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
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2022-04-22
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Joint pains, Fatigue or tirednessAdult check-in
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2022-04-23
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Joint pains, Fatigue or tirednessAdult check-in
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2022-04-24
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Joint pains, Fatigue or tirednessAdult check-in
- 2022-04-25
- 2022-04-26
- 2022-04-27
- 2022-05-04
- 2022-05-11
- 2022-05-18
- 2022-05-25
- 2022-06-01
- 2022-07-20
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2022-09-13
Dose 5 — Moderna
- 2022-10-08
- 2022-10-11
- 2022-10-18
- 2022-10-25
- 2022-12-13
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2023-03-14
Survey response — 6 months, dose 5MedDRA: COVID-19, Dyspnoea, Myocardial infarction — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit, HospitalizationMedDRA releases: 2024-11
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2023-03-14
Report sent to call center — 6 months, dose 5Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
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2023-03-15
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-27 | Moderna | |
| 2 | 2021-02-24 | Moderna | |
| 3 | 2021-10-24 | Moderna | No |
| 4 | 2022-04-20 | Moderna | No |
| 5 | 2022-09-13 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Minor indigestion
Systemic reaction (other): Unusual odor from orifices
Release 4 — day 0, dose 2
Systemic reaction (other): Brief numbness of right nostril and minor transient right jaw pain
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Right nostril feels numb
Systemic reaction (other): Right nostril numbness fading but now bruising and redness appeared on numb site.
Systemic reaction (other): Bruising/redness on right nostril and adjacent cheek in areas that went numb
Systemic reaction (other): Nostril bruising continues
Systemic reaction (other): Bruise on right nostril where it was numb after shot
Systemic reaction (other): Nose bruise continues on site of original numbness
Release 5 — day 7, dose 2
Systemic reaction (other): Bruise on nostril where numbness arose right after vaccine
Release 5 — day 21, dose 2
Symptoms: Headache, fatigue, joint aches
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 | COVID-19 | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Myocardial infarction | · | · | ✓ |
| SRO | Contusion | ✓ | ✓ | ✓ |
| SRO | Dyspepsia | ✓ | ✓ | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Intranasal hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Pain in jaw | ✓ | ✓ | ✓ |
| SRO | Parosmia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release