4G5-14961-60512
5 vaccinations
3 coded responses
63 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 481 / MI
- Registered
- 2021-03-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-03
Registered in v-safe
-
2021-03-03
Dose 1 — Moderna
- 2021-03-03
-
2021-03-04
Survey response — days 1–6 daily, dose 1MedDRA: Chills, Fatigue — Feeling: GoodFree text: Yesterday, later in the day, after completing this, I did experience fatigue, chills for 60 minutes. I went to bed for the night and have had no symptoms today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-05
- 2021-03-06
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-17
- 2021-03-24
-
2021-03-31
Dose 2 — Moderna
-
2021-03-31
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-02
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-14
-
2021-04-21
Survey response — day 21, dose 2MedDRA: Lacrimation increased, Medical counselling, Office visit, Scleral oedema — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: My left eye has been tearing/swollen white area for weeks, I believe beginning a week after my first shot. I didnt connect it to the vaccine until I visited my eye doctor yesterday and we wondered together if it could be related. · Healthcare visit (other): Eye doctor officeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-21
Report sent to call center — day 21, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-29
- 2021-05-05
- 2021-05-12
- 2021-06-30
- 2021-09-29
-
2021-10-28
Dose 3 — Moderna
-
2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-11
- 2021-11-18
- 2021-11-25
- 2021-12-02
- 2021-12-09
- 2022-01-27
- 2022-03-01
-
2022-03-01
Call successfulDoes not wish to fill out VAERS report
-
2022-04-12
Dose 4 — Moderna
- 2022-04-12
-
2022-04-13
Survey response — days 1–6 daily, dose 4MedDRA: Brain fog, Headache, Pain, Self-medication — Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: The headache is more of a fogginess. But whole body was achy all night long until I took two ibuprofen.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-14
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Redness · Chills, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-04-15
-
2022-04-16
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Redness · Fatigue or tirednessAdult check-in
- 2022-04-17
- 2022-04-18
- 2022-04-19
- 2022-04-26
- 2022-05-03
- 2022-05-10
- 2022-05-17
- 2022-05-25
- 2022-07-12
-
2022-09-12
Dose 5 — Moderna
- 2022-09-12
-
2022-09-16
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Redness, Itching · Fatigue or tirednessAdult check-in
- 2022-09-17
- 2022-09-18
- 2022-09-19
- 2022-09-26
- 2022-10-03
- 2022-10-10
- 2022-10-19
- 2022-10-24
- 2022-12-12
- 2023-03-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-03 | Moderna | |
| 2 | 2021-03-31 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
| 4 | 2022-04-12 | Moderna | No |
| 5 | 2022-09-12 | Moderna | No |
Call center
1 call center case
1 successful
1 wait over 3 months for a first call
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Yesterday, later in the day, after completing this, I did experience fatigue, chills for 60 minutes. I went to bed for the night and have had no symptoms today.
Release 7 — day 21, dose 2
Symptoms: My left eye has been tearing/swollen white area for weeks, I believe beginning a week after my first shot. I didnt connect it to the vaccine until I visited my eye doctor yesterday and we wondered together if it could be related.
Healthcare visit (other): Eye doctor office
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): The headache is more of a fogginess. But whole body was achy all night long until I took two ibuprofen.
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 | Lacrimation increased | ✓ | ✓ | ✓ |
| SD | Medical counselling | ✓ | ✓ | ✓ |
| SD | Scleral oedema | ✓ | ✓ | ✓ |
| SRO | Brain fog | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Self-medication | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release