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
-
2021-03-15
Dose 1 — Moderna
-
2021-04-13
Registered in v-safe
-
2021-04-13
Dose 2 — Moderna
- 2021-04-13
-
2021-04-14
Survey response — days 1–6 daily, dose 2MedDRA: Oedema peripheral — Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Mild swelling in armpit, same arm as injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-15
Survey response — days 1–6 daily, dose 2MedDRA: Axillary pain, Oedema peripheral — Feeling: Good · Site: Itching · Muscle or body achesFree text: Slight swelling and irritation in armpit; injection armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-16
Survey response — days 1–6 daily, dose 2MedDRA: Injection site rash, Lymphadenopathy, Pruritus — Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness, NauseaFree 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
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2021-04-17
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy — Feeling: Good · Site: Redness, Itching · NauseaFree text: Slightly swollen lymph nodes, injection armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-19
- 2021-04-20
- 2021-04-27
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2021-05-04
Survey response — day 21, dose 2MedDRA: Injection site pruritus — Feeling: GoodFree text: Continuing to experience slight itching at injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-11
- 2021-05-25
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2021-07-13
Survey response — 3 months, dose 2MedDRA: 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 consultationFree text: Symptoms: Bronchitis, sinus infection, and asthma flair up · Healthcare visit (other): Face to face doctor visitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-13
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-21
- 2021-07-22
- 2021-10-12
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2022-04-13
Survey response — 12 months, dose 2MedDRA: Retinal exudates — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree 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 yetMedDRA releases: 2024-11 · check-in free text available
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2022-04-13
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-04-21
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2022-04-26
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-15 | Moderna | |
| 2 | 2021-04-13 | Moderna |
Call center
2 call center cases
2 successful
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Mild swelling in armpit, same arm as injection site
Systemic reaction (other): Slight swelling and irritation in armpit; injection arm
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.
Systemic reaction (other): Slightly swollen lymph nodes, injection arm
Release 8 — day 21, dose 2
Symptoms: Continuing to experience slight itching at injection site
Release 9 — 3 months, dose 2
Symptoms: Bronchitis, sinus infection, and asthma flair up
Healthcare visit (other): Face to face doctor visit
Release 11 — 12 months, dose 2
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SD | Asthma | ✓ | ✓ | ✓ |
| SD | Bronchitis | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Retinal exudates | · | · | ✓ |
| SD | Sinusitis | ✓ | ✓ | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Injection site rash | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Oedema peripheral | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release