4KW-22513-79867
5 vaccinations
30 coded responses
55 check-ins
29 free-text entries
14 call cases
- Sex
- —
- Age at first dose
- 66+
- ZIP prefix
- 060 / CT
- Registered
- 2021-02-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-02-10
Dose 1 — Moderna
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2021-02-11
Registered in v-safe
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2021-02-11
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
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2021-02-12
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
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2021-02-13
Survey response — days 1–6 daily, dose 1MedDRA: Sensory disturbance — Feeling: GoodFree text: R nipple sensitivityMedDRA 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 1MedDRA: Nasal congestion — Feeling: GoodFree text: stuffy noseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-16
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: Good · Be unable to do your normal daily activitiesFree text: I felt atypically light-headed for many hours YESTERDAY, 2.15, but now feel thoroughly better.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-17
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2021-02-24
Survey response — day 14, dose 1MedDRA: Nipple pain — Feeling: GoodFree text: Right nipple & areolar tendernessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
- 2021-03-10
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2021-03-12
Dose 2 — Moderna
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2021-03-12
Survey response — day 0, dose 2MedDRA: Nipple pain — Feeling: GoodFree text: slowly resolving contralateral [right] nipple & areolar tenderness which started after Moderna dose #1MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-13
Survey response — days 1–6 daily, dose 2MedDRA: Burning sensation, Nipple pain — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Right Nipple Tenderness & slight burningMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-14
Survey response — days 1–6 daily, dose 2MedDRA: Nipple pain — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: minor right nipple & areolar tendernessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-15
- 2021-03-16
- 2021-03-17
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2021-03-18
Survey response — days 1–6 daily, dose 2MedDRA: Nipple pain — Feeling: GoodFree text: slight right nipple tendernessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-19
- 2021-03-26
- 2021-04-02
- 2021-04-09
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2021-04-16
Survey response — day 35, dose 2MedDRA: Constipation — Feeling: GoodFree text: ConstipationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-23
Survey response — day 42, dose 2MedDRA: Back pain, Sacral pain, Unevaluable event — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Severe lower lumbar & right sacral pain · Healthcare visit (other): Acute RPTMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-23
Report sent to call center — day 42, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-11
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2021-09-10
Survey response — 6 months, dose 2MedDRA: Anaemia, Chronic kidney disease, Pre-existing disease, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Symptoms: State IV Chronic Renal Failure; worsened Anemia of Chronic Disease · Healthcare visit (other): Transfusions x 2MedDRA releases: 2024-11 · check-in free text available
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2021-09-10
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-09-11
Dose 3 — ModernaCo-administered: yes
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2021-09-13
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-09-13
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2021-09-14
Survey response — days 1–6 daily, dose 3MedDRA: Nasal congestion — Feeling: Fair · Site: Pain, ItchingFree text: Nasal congestionMedDRA releases: 2024-11 · check-in free text available
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2021-09-15
Survey response — days 1–6 daily, dose 3MedDRA: Cough, Eye pruritus, Nasal congestion — Feeling: Fair · Site: Pain, ItchingFree text: nasal congestion, eye itchiness, occasional coughMedDRA releases: 2024-11 · check-in free text available
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2021-09-17
Survey response — days 1–6 daily, dose 3MedDRA: Wheezing — Feeling: Good · Site: ItchingFree text: slight end inspiration wheeze which may not be relatedMedDRA releases: 2024-11 · check-in free text available
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2021-09-18
Survey response — day 7, dose 3MedDRA: Cough, Wheezing — Feeling: GoodFree text: intermittent end-expiratory wheeze & cough, may be unrelatedMedDRA releases: 2024-11 · check-in free text available
- 2021-09-25
- 2021-10-02
- 2021-10-11
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2021-10-16
Survey response — day 35, dose 3MedDRA: Limb discomfort, Physiotherapy — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Right foot discomfort · Healthcare visit (other): Physical Therapy visitMedDRA releases: 2024-11 · check-in free text available
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2021-10-16
Report sent to call center — day 35, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2021-10-20
- 2021-10-23
- 2021-12-11
- 2022-03-12
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2022-04-13
Dose 4 — ModernaCo-administered: Shingles
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2022-04-15
Survey response — days 1–6 daily, dose 4MedDRA: Unevaluable event — Feeling: Good · Site: Pain, ItchingFree text: Well-tolerated so farMedDRA releases: 2024-11 · check-in free text available
- 2022-04-16
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2022-04-17
Survey response — days 1–6 daily, dose 4MedDRA: Musculoskeletal discomfort — Feeling: Good · Joint painsFree text: Left shoulder discomfort [near injection site]MedDRA releases: 2024-11 · check-in free text available
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2022-04-19
Survey response — days 1–6 daily, dose 4MedDRA: Musculoskeletal discomfort, Physiotherapy — Feeling: Good · Site: Pain · Joint pains · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Shoulder discomfort on the side of the injection · Healthcare visit (other): Physical TherapyMedDRA releases: 2024-11 · check-in free text available
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2022-04-19
Report sent to call center — days 1–6 daily, dose 4Get care from a doctor or other healthcare professional1 call case(s)
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2022-04-20
Survey response — day 7, dose 4MedDRA: Unevaluable event — Feeling: Good · Site: Pain · Joint painsFree text: Left ShoulderMedDRA releases: 2024-11 · check-in free text available
- 2022-04-20
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2022-04-20
Call successfulParticipant prefers to complete VAERS report online
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2022-04-20
Call successfulParticipant prefers to complete VAERS report online
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2022-04-20
Call successfulParticipant prefers to complete VAERS report online
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2022-04-20
Call successfulParticipant prefers to complete VAERS report online
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2022-05-06
Survey response — day 21, dose 4MedDRA: Meniscus removal, Surgery — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: I just had an anesthesia for a right knee meniscectomy · Healthcare visit (other): SurgeryMedDRA releases: 2024-11 · check-in free text available
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2022-05-06
Report sent to call center — day 21, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2022-05-10
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2022-05-11
Survey response — day 28, dose 4MedDRA: Bursitis, Meniscus removal, Physiotherapy, Tendonitis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: L shoulder bursitis or tendonitis persists, Possibly secondary to the 2nd Booster. An unrelated right arthroscopic meniscectomy was performed. · Healthcare visit (other): Ongoing PTMedDRA releases: 2024-11 · check-in free text available
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2022-05-11
Report sent to call center — day 28, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-05-12
- 2022-05-12
- 2022-05-12
- 2022-05-12
- 2022-05-12
- 2022-05-12
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2022-05-18
Survey response — day 35, dose 4MedDRA: Exposure to SARS-CoV-2, Office visit, Tendonitis — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Left Biceps Tendonitis ; contact exposure to Covid but did not get infected · Healthcare visit (other): Office Visits to Orthopedist & PTMedDRA releases: 2024-11 · check-in free text available
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2022-05-18
Report sent to call center — day 35, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2022-05-18
- 2022-05-18
- 2022-05-18
- 2022-05-18
- 2022-05-18
- 2022-05-19
- 2022-05-19
- 2022-05-19
- 2022-05-19
- 2022-05-24
- 2022-05-24
- 2022-05-24
- 2022-07-15
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2022-10-04
Dose 5 — ModernaCo-administered: Flu
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2022-10-06
Survey response — days 1–6 daily, dose 5MedDRA: Adverse reaction, Arthralgia, Headache, Medical counselling, Myalgia, Nausea, Office visit, Pyrexia — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Systemic reaction (other): Yes. I had a systemic reaction to my vaccination on 4-5 October with fever of 102.7, headache, fatigue, arthralgias, myalgias, & nausea. These have all resolved after 60 hours. · Healthcare visit (other): Texting, telemessaging, & an in-person examinationMedDRA releases: 2024-11 · check-in free text available
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2022-10-06
Report sent to call center — days 1–6 daily, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-10-07
- 2022-10-07
- 2022-10-09
- 2022-10-10
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2022-10-11
Survey response — day 7, dose 5MedDRA: Unevaluable event — Feeling: Good · Joint pains · Get care from a doctor or other healthcare professionalFree text: RPT visitMedDRA releases: 2024-11 · check-in free text available
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2022-10-11
Report sent to call center — day 7, dose 5Get care from a doctor or other healthcare professional1 call case(s)
- 2022-10-12
- 2022-10-12
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2022-10-18
Survey response — day 14, dose 5MedDRA: Emergency care, Gout — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: An attack of presumed Gout in the intratalar joints of my R foot on 10.14 requiring an ED visit, imaging, & Rx with oral steroidsMedDRA releases: 2024-11 · check-in free text available
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2022-10-18
Report sent to call center — day 14, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2022-10-19
- 2022-10-19
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2022-10-26
Survey response — day 21, dose 5MedDRA: Arthralgia, Back pain, Physiotherapy — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Left hip & lower right back pain · Healthcare visit (other): PT sessionMedDRA releases: 2024-11 · check-in free text available
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2022-10-26
Report sent to call center — day 21, dose 5Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-10-27
- 2022-10-27
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2022-11-01
Survey response — day 28, dose 5MedDRA: Gout, Physiotherapy, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Symptoms: L ankle gouty Mobilisation Flare · Healthcare visit (other): Physical FherapyMedDRA releases: 2024-11 · check-in free text available
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2022-11-01
Report sent to call center — day 28, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-11-02
- 2022-11-02
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2022-11-08
Survey response — day 35, dose 5MedDRA: Hyperkalaemia, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Hyperkalemia of 6.2 · Healthcare visit (other): New medication & f/u lab studyMedDRA releases: 2024-11 · check-in free text available
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2022-11-08
Report sent to call center — day 35, dose 5Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-11-09
- 2022-11-09
- 2022-11-09
- 2022-11-09
- 2022-11-09
- 2022-11-09
- 2022-11-09
- 2022-11-09
- 2022-11-09
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2023-04-06
Survey response — 6 months, dose 5MedDRA: Fibula fracture, Foot fracture, Hyperkalaemia, Joint dislocation, Paralysis — 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 · Emergency room or emergency department visit, HospitalizationMedDRA releases: 2024-11
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2023-04-06
Report sent to call center — 6 months, dose 5Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2023-04-07
- 2023-04-07
- 2023-04-07
- 2023-04-07
- 2023-04-07
- 2023-04-07
- 2023-04-07
- 2023-04-07
- 2023-04-07
- 2023-04-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-10 | Moderna | |
| 2 | 2021-03-12 | Moderna | |
| 3 | 2021-09-11 | Moderna | Yes |
| 4 | 2022-04-13 | Moderna | Shingles |
| 5 | 2022-10-04 | Moderna | Flu |
Call center
14 call center cases
4 successful · 10 unsuccessful
1 wait over 3 months for a first call
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): R nipple sensitivity
Systemic reaction (other): stuffy nose
Systemic reaction (other): I felt atypically light-headed for many hours YESTERDAY, 2.15, but now feel thoroughly better.
Release 4 — day 14, dose 1
Symptoms: Right nipple & areolar tenderness
Release 5 — day 0, dose 2
Systemic reaction (other): slowly resolving contralateral [right] nipple & areolar tenderness which started after Moderna dose #1
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Right Nipple Tenderness & slight burning
Systemic reaction (other): minor right nipple & areolar tenderness
Systemic reaction (other): slight right nipple tenderness
Release 7 — day 35, dose 2
Symptoms: Constipation
Release 7 — day 42, dose 2
Release 9 — 6 months, dose 2
Symptoms: State IV Chronic Renal Failure; worsened Anemia of Chronic Disease
Healthcare visit (other): Transfusions x 2
Release 9 — days 1–6 daily, dose 3
Systemic reaction (other): Nasal congestion
Systemic reaction (other): nasal congestion, eye itchiness, occasional cough
Systemic reaction (other): slight end inspiration wheeze which may not be related
Release 9 — day 7, dose 3
Systemic reaction (other): intermittent end-expiratory wheeze & cough, may be unrelated
Release 10 — day 35, dose 3
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Well-tolerated so far
Systemic reaction (other): Left shoulder discomfort [near injection site]
Systemic reaction (other): Shoulder discomfort on the side of the injection
Healthcare visit (other): Physical Therapy
Release 11 — day 7, dose 4
Systemic reaction (other): Left Shoulder
Release 11 — day 21, dose 4
Symptoms: I just had an anesthesia for a right knee meniscectomy
Healthcare visit (other): Surgery
Release 11 — day 28, dose 4
Symptoms: L shoulder bursitis or tendonitis persists, Possibly secondary to the 2nd Booster. An unrelated right arthroscopic meniscectomy was performed.
Healthcare visit (other): Ongoing PT
Release 11 — day 35, dose 4
Symptoms: Left Biceps Tendonitis ; contact exposure to Covid but did not get infected
Healthcare visit (other): Office Visits to Orthopedist & PT
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Yes. I had a systemic reaction to my vaccination on 4-5 October with fever of 102.7, headache, fatigue, arthralgias, myalgias, & nausea. These have all resolved after 60 hours.
Healthcare visit (other): Texting, telemessaging, & an in-person examination
Release 12 — day 7, dose 5
Healthcare visit (other): RPT visit
Release 12 — day 14, dose 5
Symptoms: An attack of presumed Gout in the intratalar joints of my R foot on 10.14 requiring an ED visit, imaging, & Rx with oral steroids
Release 12 — day 21, dose 5
Release 12 — day 28, dose 5
Release 12 — day 35, dose 5
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 | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| HCVO | Physiotherapy | · | · | ✓ |
| HCVO | Surgery | · | · | ✓ |
| HCVO | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Anaemia | · | · | ✓ |
| SD | Arthralgia | · | · | ✓ |
| SD | Back pain | ✓ | ✓ | ✓ |
| SD | Bursitis | · | · | ✓ |
| SD | Chronic kidney disease | · | · | ✓ |
| SD | Constipation | ✓ | ✓ | ✓ |
| SD | Emergency care | · | · | ✓ |
| SD | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Fibula fracture | · | · | ✓ |
| SD | Foot fracture | · | · | ✓ |
| SD | Gout | · | · | ✓ |
| SD | Hyperkalaemia | · | · | ✓ |
| SD | Joint dislocation | · | · | ✓ |
| SD | Limb discomfort | · | · | ✓ |
| SD | Meniscus removal | · | · | ✓ |
| SD | Nipple pain | ✓ | ✓ | ✓ |
| SD | Paralysis | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Sacral pain | ✓ | ✓ | ✓ |
| SD | Tendonitis | · | · | ✓ |
| SRO | Adverse reaction | · | · | ✓ |
| SRO | Arthralgia | · | · | ✓ |
| SRO | Burning sensation | ✓ | ✓ | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Eye pruritus | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Musculoskeletal discomfort | · | · | ✓ |
| SRO | Myalgia | · | · | ✓ |
| SRO | Nasal congestion | ✓ | ✓ | ✓ |
| SRO | Nausea | · | · | ✓ |
| SRO | Nipple pain | ✓ | ✓ | ✓ |
| SRO | Pyrexia | · | · | ✓ |
| SRO | Sensory disturbance | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
| SRO | Wheezing | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release