3EN-14853-03236
2 vaccinations
6 coded responses
10 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 829 / WY
- Registered
- 2021-04-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
X6F-19559-95547
Child or adolescent in my care · Female · 2021-12-02
Timeline
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2021-03-26
Dose 1 — Moderna
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2021-04-23
Registered in v-safe
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2021-04-23
Dose 2 — Moderna
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2021-04-25
Survey response — days 1–6 daily, dose 2MedDRA: Mobility decreased — Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to workFree text: Resticted mobility in injection arm. (Cant undo bra)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-26
Survey response — days 1–6 daily, dose 2MedDRA: Injected limb mobility decreased — Feeling: Good · Joint pains, Muscle or body achesFree text: In shot arm i have reduced mobility/reduced flexibility in shoulder area. Can not reach my bra to unfasten still. This is since 1st shot and continues.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-28
Survey response — days 1–6 daily, dose 2MedDRA: Hypoaesthesia, Paraesthesia — Feeling: Fair · Joint pains, Muscle or body achesFree text: Numbness and tingling in arm with shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-29
Survey response — days 1–6 daily, dose 2MedDRA: Movement disorder — Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Still restricted movement in arm/shoulderMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-30
- 2021-05-07
- 2021-05-15
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2021-05-21
Survey response — day 28, dose 2MedDRA: Chills, Diarrhoea, Fatigue, Headache, Myalgia, Pain, Pyrexia, Vomiting — Feeling: Poor · Be unable to work, Be unable to do your normal daily activitiesFree text: Fever, chills, headache, muscle pain and body ache, tired, diarrhea and vomitingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-04
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2021-10-24
Survey response — 6 months, dose 2MedDRA: Illness, Impaired work ability, Influenza like illness, Malaise, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: I did get quite ill and missed work. It was flu like but more in chest. Tested negative for covid during sickness. Sickness lasted 8-10 days. Have been vaccinated for flu this year.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-26 | Moderna | |
| 2 | 2021-04-23 | Moderna |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Resticted mobility in injection arm. (Cant undo bra)
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): In shot arm i have reduced mobility/reduced flexibility in shoulder area. Can not reach my bra to unfasten still. This is since 1st shot and continues.
Systemic reaction (other): Numbness and tingling in arm with shot
Systemic reaction (other): Still restricted movement in arm/shoulder
Release 8 — day 28, dose 2
Symptoms: Fever, chills, headache, muscle pain and body ache, tired, diarrhea and vomiting
Release 10 — 6 months, dose 2
Symptoms: I did get quite ill and missed work. It was flu like but more in chest. Tested negative for covid during sickness. Sickness lasted 8-10 days. Have been vaccinated for flu this year.
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 | Chills | ✓ | ✓ | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Illness | · | · | ✓ |
| SD | Impaired work ability | · | · | ✓ |
| SD | Influenza like illness | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Vomiting | ✓ | ✓ | ✓ |
| SRO | Hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Injected limb mobility decreased | ✓ | ✓ | ✓ |
| SRO | Mobility decreased | ✓ | ✓ | ✓ |
| SRO | Movement disorder | ✓ | ✓ | ✓ |
| SRO | Paraesthesia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release