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3MT-19188-81479

2 vaccinations 8 coded responses 12 check-ins 8 free-text entries 0 call cases
Sex
Female
Age at first dose
56-60
ZIP prefix
535 / WI
Registered
2021-04-22
Relationship
Self
Race
White
Ethnicity
N/A

Timeline

  1. 2021-03-26
    Dose 1 — Moderna
  2. 2021-04-22
    Registered in v-safe
  3. 2021-04-22
    Dose 2 — Moderna
  4. 2021-04-22
    Health check-in — day 0, dose 2
    Feeling: Fair · Site: Itching · Chills, Headache, Nausea
    Adult check-in
  5. 2021-04-23
    Survey response — days 1–6 daily, dose 2
    MedDRA: Vision blurred — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities
    Free text: Blurred vision
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-04-24
    Survey response — days 1–6 daily, dose 2
    MedDRA: Axillary mass, Axillary pain — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities
    Free text: It feels like a mandarin orange size painful lump in my right arm pit. Pain increases when my arm is tighter to my body.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-04-25
    Survey response — days 1–6 daily, dose 2
    MedDRA: Axillary mass, Axillary pain, Blepharospasm, Nervousness — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Painful golf ball and a half sized lump in my right armpit. Continued jumpy Left eye since first injection on 3/26/21.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-04-26
    Survey response — days 1–6 daily, dose 2
    MedDRA: Muscle twitching — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Jumpy left eye
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-04-27
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  10. 2021-04-28
    Survey response — days 1–6 daily, dose 2
    MedDRA: Axillary mass — Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Painful golf ball sized lump in right armpit. Jumpy left eye.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-04-29
    Survey response — day 7, dose 2
    MedDRA: Axillary mass, Blepharospasm — Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Painful Golfball sized lump in right armpit. Jumpy left eye.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-05-06
    Survey response — day 14, dose 2
    MedDRA: Abdominal pain upper, Asthenia, Bone pain, Chills, Diarrhoea, Fatigue, Hyperhidrosis, Myalgia, Vomiting — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Very bad stomachache with vomiting and diarrhea. Fever 100°, chills and sweats. Added pain, it feels like bone pain, and muscle aches. Very tired, no energy.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-05-22
    Health check-in — day 28, dose 2
    Feeling: Fair
    Adult check-in
  14. 2021-06-03
    Survey response — day 42, dose 2
    MedDRA: Dizziness — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Dizziness. My health is about the same except for this dizziness, which makes it worse.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-10-21
    Health check-in — 6 months, dose 2
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-26Moderna
22021-04-22Moderna

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-23

Systemic reaction (other): Blurred vision

2021-04-24

Systemic reaction (other): It feels like a mandarin orange size painful lump in my right arm pit. Pain increases when my arm is tighter to my body.

2021-04-25

Systemic reaction (other): Painful golf ball and a half sized lump in my right armpit. Continued jumpy Left eye since first injection on 3/26/21.

Release 8 — days 1–6 daily, dose 2

2021-04-26

Systemic reaction (other): Jumpy left eye

2021-04-28

Systemic reaction (other): Painful golf ball sized lump in right armpit. Jumpy left eye.

Release 8 — day 7, dose 2

2021-04-29

Systemic reaction (other): Painful Golfball sized lump in right armpit. Jumpy left eye.

Release 8 — day 14, dose 2

2021-05-06

Symptoms: Very bad stomachache with vomiting and diarrhea. Fever 100°, chills and sweats. Added pain, it feels like bone pain, and muscle aches. Very tired, no energy.

Release 8 — day 42, dose 2

2021-06-03

Symptoms: Dizziness. My health is about the same except for this dizziness, which makes it worse.

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
SDAbdominal pain upper ✓ ✓ ✓
SDAsthenia ✓ ✓ ✓
SDBone pain ✓ ✓ ✓
SDChills ✓ ✓ ✓
SDDiarrhoea ✓ ✓ ✓
SDDizziness ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDHyperhidrosis ✓ ✓ ✓
SDMyalgia ✓ ✓ ✓
SDVomiting ✓ ✓ ✓
SROAxillary mass ✓ ✓ ✓
SROAxillary pain ✓ ✓ ✓
SROBlepharospasm ✓ ✓ ✓
SROMuscle twitching ✓ ✓ ✓
SRONervousness ✓ ✓ ✓
SROVision blurred ✓ ✓ ✓

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