4KW-97490-73397
1 vaccination
12 coded responses
13 check-ins
12 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 863 / AZ
- Registered
- 2021-03-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-21
Registered in v-safe
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2021-03-21
Dose 1 — Moderna
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2021-03-22
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness, Dyspepsia, Erythema, Swelling, Tinnitus — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesFree text: Heartburn, red streaks from swelled area & two small swelled spots on my jaw that have subsided, persistant ringing of the ears, & lightheadednes off and on.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 1MedDRA: Dyspepsia, Self-medication — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body achesFree text: Mild heartburn. I have been taking antihistamines since 1 hour prior to taking the injection because of my history with allergies. Benadryl and Allegra on day one, Allegra only today.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 1MedDRA: Diarrhoea — Feeling: Fair · Site: Pain, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Super soft explosive stool, not looseMedDRA 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 1MedDRA: Eye pain, Eyelid pain — Feeling: Fair · Site: Redness, Itching · Headache, Joint pains, Fatigue or tirednessFree text: Pain in the corner of my right eye & eye lid that is new with no visible problem.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-27
Survey response — days 1–6 daily, dose 1MedDRA: Injection site erythema, Injection site pain, Injection site pruritus — Feeling: Good · Site: Pain, Redness, Itching · Joint pains, Fatigue or tirednessFree text: Since I stopped taking the antihistamines the day before yesterday, the itching, redness, and soreness has returned to the injection site, but it is mild.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-28
Survey response — day 7, dose 1MedDRA: Antiallergic therapy, Erythema, Injection site erythema, Injection site pruritus, Injection site swelling, Pruritus, Swelling — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Fatigue or tirednessFree text: I have not taken any antihistamines for 3 days, and the redness, itching, and swelling that had previously gone away has returned to my injection site. I have taken a photo for documentation.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-04
Survey response — day 14, dose 1MedDRA: Injection site erythema, Injection site inflammation, Injection site pruritus, Injection site swelling — Feeling: GoodFree text: Post-exercise and some heavy lifting I had a strange swelling of the area that seems to have bled over from my original inection site, the injection site became red again, but the new spread area was itchy and inflamed. I took photos to document it.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-11
Survey response — day 21, dose 1MedDRA: Arthralgia, Fatigue, Headache, Muscle spasms, Sneezing — Feeling: FairFree text: Joint pain, eardrum spasms, fatigue, overall increase in allergy symptoms like sneezing compared to prior years. Occasional mild headaches now... used to be very rare for me.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-19
Survey response — day 28, dose 1MedDRA: Ear discomfort, Ear disorder, Nausea, Oropharyngeal pain, Oropharyngeal spasm, Pharyngeal swelling, Respiratory tract congestion — Feeling: Fair · Be unable to work, Be unable to do your normal daily activitiesFree text: New nausea today. On 17th, throat became sore & visibly swelled on Lt side (could not see my tonsils on that side, & opening was not symetrical), but I worked a 16 hr shift wearing a mask on the 16th. Lt ear drum spasming & stuffiness continues.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-30
Survey response — day 35, dose 1MedDRA: Arthralgia, Fatigue, Muscle spasms, Myalgia, Pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Body joint & muscle soreness and mild pain persist, but have increased to Lt shoulder. Fatigue continues, eardrum spasms continue off and on but less the last few days. Overall incr in allergies persists.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-24
Survey response — 3 months, dose 1MedDRA: Arthralgia, Asthenia, Brain fog, Feeling abnormal, Gastrointestinal disorder, Muscle spasms, Myalgia, Ophthalmoplegia, Vision blurred — Feeling: FairFree text: Increased: gut/GI issues, muscle cramping off and on, joint pain & joint weakness, overall feeling strange/off, brain fog, eye fatiue and difficulty focusing vision.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-09-20
Survey response — 6 months, dose 1MedDRA: Arthralgia, Feeling abnormal, Muscle spasms, Myalgia, Nail discolouration, Pain, Pain in extremity, Vascular rupture, Vision blurred — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Little dark streaks under my fingernails in my Rt hand like ruptured capillaries with no known injury. Intermittant: burning pain to Rt upper hip & foot, blurry vision & strange sensation to Lt side of face, muscle cramping & aches, incr joint pain.MedDRA releases: 2024-11 · check-in free text available
- 2022-03-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-21 | Moderna |
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Heartburn, red streaks from swelled area & two small swelled spots on my jaw that have subsided, persistant ringing of the ears, & lightheadednes off and on.
Systemic reaction (other): Mild heartburn. I have been taking antihistamines since 1 hour prior to taking the injection because of my history with allergies. Benadryl and Allegra on day one, Allegra only today.
Systemic reaction (other): Super soft explosive stool, not loose
Systemic reaction (other): Pain in the corner of my right eye & eye lid that is new with no visible problem.
Systemic reaction (other): Since I stopped taking the antihistamines the day before yesterday, the itching, redness, and soreness has returned to the injection site, but it is mild.
Release 6 — day 7, dose 1
Systemic reaction (other): I have not taken any antihistamines for 3 days, and the redness, itching, and swelling that had previously gone away has returned to my injection site. I have taken a photo for documentation.
Release 6 — day 14, dose 1
Symptoms: Post-exercise and some heavy lifting I had a strange swelling of the area that seems to have bled over from my original inection site, the injection site became red again, but the new spread area was itchy and inflamed. I took photos to document it. cut off by CDC
Release 7 — day 21, dose 1
Symptoms: Joint pain, eardrum spasms, fatigue, overall increase in allergy symptoms like sneezing compared to prior years. Occasional mild headaches now... used to be very rare for me.
Release 7 — day 28, dose 1
Symptoms: New nausea today. On 17th, throat became sore & visibly swelled on Lt side (could not see my tonsils on that side, & opening was not symetrical), but I worked a 16 hr shift wearing a mask on the 16th. Lt ear drum spasming & stuffiness continues.
Release 8 — day 35, dose 1
Symptoms: Body joint & muscle soreness and mild pain persist, but have increased to Lt shoulder. Fatigue continues, eardrum spasms continue off and on but less the last few days. Overall incr in allergies persists.
Release 9 — 3 months, dose 1
Symptoms: Increased: gut/GI issues, muscle cramping off and on, joint pain & joint weakness, overall feeling strange/off, brain fog, eye fatiue and difficulty focusing vision.
Release 9 — 6 months, dose 1
Symptoms: Little dark streaks under my fingernails in my Rt hand like ruptured capillaries with no known injury. Intermittant: burning pain to Rt upper hip & foot, blurry vision & strange sensation to Lt side of face, muscle cramping & aches, incr joint pain. 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 | Arthralgia | ✓ | ✓ | ✓ |
| SD | Asthenia | ✓ | ✓ | ✓ |
| SD | Brain fog | ✓ | ✓ | ✓ |
| SD | Ear discomfort | ✓ | · | ✓ |
| SD | Ear disorder | ✓ | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Feeling abnormal | ✓ | ✓ | ✓ |
| SD | Gastrointestinal disorder | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site inflammation | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site swelling | ✓ | ✓ | ✓ |
| SD | Muscle spasms | ✓ | ✓ | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Nail discolouration | · | · | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Ophthalmoplegia | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Oropharyngeal spasm | ○ | ✓ | ○ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Pharyngeal swelling | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | ○ | ✓ | ○ |
| SD | Sneezing | ✓ | ✓ | ✓ |
| SD | Vascular rupture | · | · | ✓ |
| SD | Vision blurred | ✓ | ✓ | ✓ |
| SRO | Antiallergic therapy | ○ | ✓ | ○ |
| SRO | Diarrhoea | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Dyspepsia | ✓ | ✓ | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Eye pain | ✓ | ✓ | ✓ |
| SRO | Eyelid pain | ✓ | ✓ | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site pruritus | ✓ | ✓ | ✓ |
| SRO | Injection site swelling | ✓ | · | ✓ |
| SRO | Pruritus | ○ | ✓ | ○ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Swelling | ✓ | ✓ | ✓ |
| SRO | Tinnitus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release