3Z5-21081-96757
2 vaccinations
6 coded responses
11 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 491 / MI
- Registered
- 2021-03-22
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-02-20
Dose 1 — Moderna
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2021-03-19
Dose 2 — Moderna
-
2021-03-22
Registered in v-safe
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2021-03-22
Survey response — days 1–6 daily, dose 2MedDRA: Hypoaesthesia oral, Paraesthesia oral — Feeling: Fair · Site: Pain, Swelling · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaFree text: A numbing tingle sensation in my mouth and tongue.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-23
Survey response — days 1–6 daily, dose 2MedDRA: Hypoaesthesia oral, Paraesthesia oral — Feeling: Fair · Site: Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaFree text: Numbness and tingling in the mouth and tongue.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-24
Survey response — days 1–6 daily, dose 2MedDRA: Hypoaesthesia oral, Paraesthesia oral — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Tingling and numbness in the mouth and tongue. Milder than yesterday.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-25
Survey response — days 1–6 daily, dose 2MedDRA: Adverse reaction — Feeling: Good · Fatigue or tirednessFree text: Same thing about my mouth as previous days.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-26
- 2021-04-03
- 2021-04-09
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2021-04-16
Survey response — day 28, dose 2MedDRA: Pain — Feeling: FairFree text: Sore body achesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-23
- 2021-05-02
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2021-06-18
Survey response — 3 months, dose 2MedDRA: Arthralgia, Asthma, Body temperature fluctuation, Brain fog, Chills, Memory impairment, Office visit — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Foggy thoughts and memory recall. Also joint pain in my ankles and knees. I'm now waking up with my fingers clutched and popping when i stretch them out. I had a week where my body temp went up and down, chills, and a asthma like breathing. · Healthcare visit (other): Doctor follow up in person.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-18
Report sent to call center — 3 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
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2021-06-24
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-20 | Moderna | |
| 2 | 2021-03-19 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): A numbing tingle sensation in my mouth and tongue.
Systemic reaction (other): Numbness and tingling in the mouth and tongue.
Systemic reaction (other): Tingling and numbness in the mouth and tongue. Milder than yesterday.
Systemic reaction (other): Same thing about my mouth as previous days.
Release 7 — day 28, dose 2
Symptoms: Sore body aches
Release 9 — 3 months, dose 2
Symptoms: Foggy thoughts and memory recall. Also joint pain in my ankles and knees. I'm now waking up with my fingers clutched and popping when i stretch them out. I had a week where my body temp went up and down, chills, and a asthma like breathing.
Healthcare visit (other): Doctor follow up in person.
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 | Arthralgia | ✓ | ✓ | ✓ |
| SD | Asthma | ✓ | ✓ | ✓ |
| SD | Body temperature fluctuation | ✓ | ✓ | ✓ |
| SD | Brain fog | ✓ | ✓ | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Memory impairment | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Hypoaesthesia oral | ✓ | ✓ | ✓ |
| SRO | Paraesthesia oral | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release