43H-16065-31498
4 vaccinations
7 coded responses
46 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 228 / VA
- Registered
- 2021-01-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
DCE-12037-14710
Child or adolescent in my care · Male · 2021-11-22
Timeline
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2021-01-13
Dose 1 — Moderna
-
2021-01-15
Registered in v-safe
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2021-01-15
Survey response — days 1–6 daily, dose 1MedDRA: Arthralgia, Fatigue, Headache, Injection site pain, Myalgia, Pain — Feeling: Good · Site: Pain, ItchingFree text: Since I delayed in setting up Vsafe: On 1/14/21 (vaccine was received 1/13/21), I felt extremely fatigued, muscle and body aches, joint pains, and headache. I also would have considered the pain at the injection site itself to be more severe.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-16
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: All symptoms have resolved with the exception of minor pain at the injection site itself, which is really only noticed when direct contact is made (if I didn't have a rambunctious 8yr old, I probably wouldn't notice it at all)..MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-20
- 2021-01-27
- 2021-02-03
-
2021-02-10
Dose 2 — Moderna
- 2021-02-10
-
2021-02-11
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Discomfort, Pain, Sleep disorder — Feeling: Poor · Site: Pain, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: At about 6pm last night i experienced severe chills, my teeth were chattering uncontrollably. The aches and pains made it extremely difficult to get comfortable in order to sleep overnight.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-12
Survey response — days 1–6 daily, dose 2MedDRA: Discomfort, Pain — Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body achesFree text: The pain and discomfort has been very mild today and has lessened as the day wears on.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-13
Survey response — days 1–6 daily, dose 2MedDRA: Thirst, Vaccine positive rechallenge — Feeling: Good · Site: Itching · HeadacheFree text: I have realized that both with my first shot and the second that i was incredibly thirsty both times.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-14
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: Very minor pain at the injection site and only periodically.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-24
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-05-12
- 2021-08-11
-
2021-11-22
Dose 3 — Moderna
- 2021-11-22
-
2021-11-23
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body achesAdult check-in
- 2021-11-24
- 2021-11-25
- 2021-11-26
- 2021-11-27
- 2021-11-28
- 2021-12-01
- 2021-12-08
- 2021-12-13
- 2021-12-20
- 2021-12-27
- 2022-01-05
- 2022-02-21
- 2022-05-23
-
2022-09-17
Dose 4 — Moderna
- 2022-09-28
- 2022-10-01
- 2022-10-08
- 2022-10-15
-
2022-10-22
Survey response — day 35, dose 4MedDRA: Chest discomfort, Illness, Influenza, Oropharyngeal pain, Paranasal sinus discomfort, Pharyngitis streptococcal, Pre-existing disease, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Fair · 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: Started with a severe sore throat and then developed congestion/runny nose, and sinus pressure. Recently experienced tightness in my chest as well. I tested negative for COVID, flu, and strep throat. Illness may have been exacerbated by my asthma.MedDRA releases: 2024-11 · check-in free text available
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2022-10-22
Report sent to call center — day 35, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-10-26
- 2022-10-28
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2022-10-28
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-10-29
- 2022-12-17
- 2023-03-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-13 | Moderna | |
| 2 | 2021-02-10 | Moderna | |
| 3 | 2021-11-22 | Moderna | No |
| 4 | 2022-09-17 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Since I delayed in setting up Vsafe: On 1/14/21 (vaccine was received 1/13/21), I felt extremely fatigued, muscle and body aches, joint pains, and headache. I also would have considered the pain at the injection site itself to be more severe.
Systemic reaction (other): All symptoms have resolved with the exception of minor pain at the injection site itself, which is really only noticed when direct contact is made (if I didn't have a rambunctious 8yr old, I probably wouldn't notice it at all)..
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): At about 6pm last night i experienced severe chills, my teeth were chattering uncontrollably. The aches and pains made it extremely difficult to get comfortable in order to sleep overnight.
Systemic reaction (other): The pain and discomfort has been very mild today and has lessened as the day wears on.
Systemic reaction (other): I have realized that both with my first shot and the second that i was incredibly thirsty both times.
Systemic reaction (other): Very minor pain at the injection site and only periodically.
Release 12 — day 35, dose 4
Symptoms: Started with a severe sore throat and then developed congestion/runny nose, and sinus pressure. Recently experienced tightness in my chest as well. I tested negative for COVID, flu, and strep throat. Illness may have been exacerbated by my asthma. cut off by CDC
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 | Chest discomfort | · | · | ✓ |
| SD | Illness | · | · | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Paranasal sinus discomfort | · | · | ✓ |
| SD | Pharyngitis streptococcal | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Discomfort | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Sleep disorder | ✓ | ✓ | ✓ |
| SRO | Thirst | ✓ | ✓ | ✓ |
| SRO | Vaccine positive rechallenge | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release