45L-15159-31794
2 vaccinations
6 coded responses
14 check-ins
6 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 120 / NY
- Registered
- 2021-01-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2020-12-23
Dose 1 — Moderna
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2021-01-06
Registered in v-safe
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2021-01-06
Survey response — day 14, dose 1MedDRA: Bone pain, Fatigue, Injection site erythema, Injection site pain, Injection site urticaria, Pruritus — Feeling: FairFree text: I have a 9 to 10 cm urticarial wheel on my left arm at the site of the vaccine. It is violaceous in the center with an area of clearing and then a large area of erythema. Also have some fatigue, generalized pruritus, and bony pain at injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-13
Survey response — day 21, dose 1MedDRA: Asthma, Contusion, Diarrhoea — Feeling: Fair · Be unable to work, 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: I had an asthma attack last Thurs and needed solumedrol. The wheal on my arm is more bruised but improved overall. I have had semiformed diarrhea for one week.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-13
Report sent to call center — day 21, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-01-21
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2021-01-22
Dose 2 — Moderna
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2021-01-27
Survey response — days 1–6 daily, dose 2MedDRA: Myalgia, Pyrexia — Feeling: Good · Site: Redness, Swelling, ItchingFree text: I did have a low-grade fever for approximately four days afterwards and severe myalgias 24 hours after the shot was givenMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-28
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fever · Headache, Fatigue or tirednessAdult check-in
- 2021-01-29
- 2021-02-05
- 2021-02-14
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2021-02-19
Survey response — day 28, dose 2MedDRA: Fatigue, Hot flush — Feeling: FairFree text: Hot flashes and severe fatigueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-26
Survey response — day 35, dose 2MedDRA: Fatigue, Headache, Pain — Feeling: FairFree text: Fatigue and body aches, headachesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-01
- 2021-03-05
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2021-04-23
Survey response — 3 months, dose 2MedDRA: Cognitive disorder, Fatigue, Flushing, Medical counselling, Neuropathy peripheral, Vision blurred — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: I was diagnosed with side a kind released syndrome on 3/8/21 because I have been experiencing flushing, fatigue, neuropathy, blurry vision, cognitive difficulty, and dyspnea. He started me on Claritin which helped. I did not need steroids. · Healthcare visit (other): I am a physician so I just reached out to him directly.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-23
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-16
- 2021-07-23
- 2022-01-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-23 | Moderna | |
| 2 | 2021-01-22 | Moderna |
Call center
2 call center cases
2 unsuccessful
Free text
Release 1 — day 14, dose 1
Symptoms: I have a 9 to 10 cm urticarial wheel on my left arm at the site of the vaccine. It is violaceous in the center with an area of clearing and then a large area of erythema. Also have some fatigue, generalized pruritus, and bony pain at injection site. cut off by CDC
Release 1 — day 21, dose 1
Symptoms: I had an asthma attack last Thurs and needed solumedrol. The wheal on my arm is more bruised but improved overall. I have had semiformed diarrhea for one week.
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): I did have a low-grade fever for approximately four days afterwards and severe myalgias 24 hours after the shot was given
Release 4 — day 28, dose 2
Symptoms: Hot flashes and severe fatigue
Release 4 — day 35, dose 2
Symptoms: Fatigue and body aches, headaches
Release 7 — 3 months, dose 2
Symptoms: I was diagnosed with side a kind released syndrome on 3/8/21 because I have been experiencing flushing, fatigue, neuropathy, blurry vision, cognitive difficulty, and dyspnea. He started me on Claritin which helped. I did not need steroids.
Healthcare visit (other): I am a physician so I just reached out to him directly.
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 | Medical counselling | ✓ | ✓ | ✓ |
| SD | Asthma | ✓ | ✓ | ✓ |
| SD | Bone pain | ✓ | ✓ | ✓ |
| SD | Cognitive disorder | ✓ | ✓ | ✓ |
| SD | Contusion | ✓ | ✓ | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Flushing | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Hot flush | ✓ | ✓ | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Injection site urticaria | ✓ | ✓ | ✓ |
| SD | Neuropathy peripheral | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Vision blurred | ✓ | ✓ | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release