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3JM-59303-48666

2 vaccinations 7 coded responses 14 check-ins 7 free-text entries 2 call cases
Sex
Female
Age at first dose
51-55
ZIP prefix
775 / TX
Registered
2021-04-13
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-15
    Dose 1 — Moderna
  2. 2021-04-13
    Registered in v-safe
  3. 2021-04-13
    Dose 2 — Moderna
  4. 2021-04-13
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  5. 2021-04-14
    Survey response — days 1–6 daily, dose 2
    MedDRA: Oedema peripheral — Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Mild swelling in armpit, same arm as injection site
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-04-15
    Survey response — days 1–6 daily, dose 2
    MedDRA: Axillary pain, Oedema peripheral — Feeling: Good · Site: Itching · Muscle or body aches
    Free text: Slight swelling and irritation in armpit; injection arm
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-04-16
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site rash, Lymphadenopathy, Pruritus — Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness, Nausea
    Free text: Lymph nodes still a bit swollen and irritated on injection site arm. Itchy overall: torso, breasts, both arms, very mild, no rash except for injection site.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-04-17
    Survey response — days 1–6 daily, dose 2
    MedDRA: Lymphadenopathy — Feeling: Good · Site: Redness, Itching · Nausea
    Free text: Slightly swollen lymph nodes, injection arm
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-04-19
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Itching · None
    Adult check-in
  10. 2021-04-20
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  11. 2021-04-27
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-05-04
    Survey response — day 21, dose 2
    MedDRA: Injection site pruritus — Feeling: Good
    Free text: Continuing to experience slight itching at injection site
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-05-11
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-05-25
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-07-13
    Survey response — 3 months, dose 2
    MedDRA: Asthma, Bronchitis, Office visit, Pre-existing disease, Sinusitis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Symptoms: Bronchitis, sinus infection, and asthma flair up · Healthcare visit (other): Face to face doctor visit
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-07-13
    Report sent to call center — 3 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  17. 2021-07-21
  18. 2021-07-22
  19. 2021-10-12
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  20. 2022-04-13
    Survey response — 12 months, dose 2
    MedDRA: Retinal exudates — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: I have a cotton wool spot on left retina. It may be totally unrelated of course. But tons of blood tests and brain MRI have turned up no underlying cause as of yet
    MedDRA releases: 2024-11 · check-in free text available
  21. 2022-04-13
    Report sent to call center — 12 months, dose 2
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  22. 2022-04-21
  23. 2022-04-26
    Call successful
    Does not wish to fill out VAERS report

Vaccinations

DoseDateManufacturerCo-administered
12021-03-15Moderna
22021-04-13Moderna

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-14

Systemic reaction (other): Mild swelling in armpit, same arm as injection site

2021-04-15

Systemic reaction (other): Slight swelling and irritation in armpit; injection arm

2021-04-16

Systemic reaction (other): Lymph nodes still a bit swollen and irritated on injection site arm. Itchy overall: torso, breasts, both arms, very mild, no rash except for injection site.

2021-04-17

Systemic reaction (other): Slightly swollen lymph nodes, injection arm

Release 8 — day 21, dose 2

2021-05-04

Symptoms: Continuing to experience slight itching at injection site

Release 9 — 3 months, dose 2

2021-07-13

Symptoms: Bronchitis, sinus infection, and asthma flair up
Healthcare visit (other): Face to face doctor visit

Release 11 — 12 months, dose 2

2022-04-13

Symptoms: I have a cotton wool spot on left retina. It may be totally unrelated of course. But tons of blood tests and brain MRI have turned up no underlying cause as of yet

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

FieldPreferred term2021-092023-042024-11
HCVOOffice visit ✓ ✓ ✓
SDAsthma ✓ ✓ ✓
SDBronchitis ✓ ✓ ✓
SDInjection site pruritus ✓ ✓ ✓
SDPre-existing disease ✓ ✓ ✓
SDRetinal exudates · · ✓
SDSinusitis ✓ ✓ ✓
SROAxillary pain ✓ ✓ ✓
SROInjection site rash ✓ ✓ ✓
SROLymphadenopathy ✓ ✓ ✓
SROOedema peripheral ✓ ✓ ✓
SROPruritus ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release