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
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2021-03-26
Dose 1 — Moderna
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2021-04-22
Registered in v-safe
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2021-04-22
Dose 2 — Moderna
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2021-04-22
Health check-in — day 0, dose 2Feeling: Fair · Site: Itching · Chills, Headache, NauseaAdult check-in
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2021-04-23
Survey response — days 1–6 daily, dose 2MedDRA: 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 activitiesFree text: Blurred visionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-24
Survey response — days 1–6 daily, dose 2MedDRA: 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 activitiesFree 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
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2021-04-25
Survey response — days 1–6 daily, dose 2MedDRA: 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 activitiesFree 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
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2021-04-26
Survey response — days 1–6 daily, dose 2MedDRA: 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 activitiesFree text: Jumpy left eyeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-04-28
Survey response — days 1–6 daily, dose 2MedDRA: Axillary mass — Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree 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
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2021-04-29
Survey response — day 7, dose 2MedDRA: Axillary mass, Blepharospasm — Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Painful Golfball sized lump in right armpit. Jumpy left eye.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-06
Survey response — day 14, dose 2MedDRA: Abdominal pain upper, Asthenia, Bone pain, Chills, Diarrhoea, Fatigue, Hyperhidrosis, Myalgia, Vomiting — Feeling: Fair · Be unable to do your normal daily activitiesFree 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
- 2021-05-22
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2021-06-03
Survey response — day 42, dose 2MedDRA: Dizziness — Feeling: Fair · Be unable to do your normal daily activitiesFree 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
- 2021-10-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-26 | Moderna | |
| 2 | 2021-04-22 | Moderna |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Blurred vision
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.
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
Systemic reaction (other): Jumpy left eye
Systemic reaction (other): Painful golf ball sized lump in right armpit. Jumpy left eye.
Release 8 — day 7, dose 2
Systemic reaction (other): Painful Golfball sized lump in right armpit. Jumpy left eye.
Release 8 — day 14, dose 2
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
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Abdominal pain upper | ✓ | ✓ | ✓ |
| SD | Asthenia | ✓ | ✓ | ✓ |
| SD | Bone pain | ✓ | ✓ | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Hyperhidrosis | ✓ | ✓ | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Vomiting | ✓ | ✓ | ✓ |
| SRO | Axillary mass | ✓ | ✓ | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Blepharospasm | ✓ | ✓ | ✓ |
| SRO | Muscle twitching | ✓ | ✓ | ✓ |
| SRO | Nervousness | ✓ | ✓ | ✓ |
| SRO | Vision blurred | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release