4LU-21766-55428
3 vaccinations
4 coded responses
13 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 151 / PA
- Registered
- 2021-03-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-04
Dose 1 — Moderna
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2021-03-13
Registered in v-safe
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2021-03-13
Health check-in — day 7, dose 1Feeling: Good · Site: Pain, Redness, Swelling, Itching · NoneAdult check-in
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2021-03-18
Survey response — day 14, dose 1MedDRA: Erythema, Fatigue, Immunisation reaction, Pain, Pruritus — 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 consultationFree text: Covid-arm symptoms spread down my arm to the elbow and around the front of the muscle and to the back. Extreme itchiness, fatigue and body aches. Started letting up yesterday. Arm still red. Steroid cream,& BenedrylMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-18
Report sent to call center — day 14, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-26
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2021-04-01
Dose 2 — Moderna
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2021-04-15
Survey response — day 14, dose 2MedDRA: Erythema, Peripheral swelling, Self-medication — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Red itchy swollen upper arm · Healthcare visit (other): Used medication from a previous visitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-15
Report sent to call center — day 14, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-22
- 2021-04-29
- 2021-05-07
- 2021-05-15
- 2021-07-01
- 2021-10-01
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2021-11-05
Dose 3 — ModernaCo-administered: Flu
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2022-01-20
Call successfulParticipant prefers to complete VAERS report online
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2022-04-01
Survey response — 12 months, dose 2MedDRA: Impaired work ability, Laryngitis, Nasopharyngitis, Speech disorder — Feeling: Good · Be unable to do your normal daily activitiesFree text: Had a cold and laryngitis in February. Couldn't talk. So couldn't do my jobMedDRA releases: 2024-11 · check-in free text available
- 2022-05-06
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2022-11-05
Survey response — 12 months, dose 3MedDRA: Anaemia, Hiatus hernia, Pulmonary embolism — 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 · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit, HospitalizationFree text: Giant hiatel hernia,extreme anemia, pulmonary embolismsMedDRA releases: 2024-11 · check-in free text available
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2022-11-05
Report sent to call center — 12 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
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2022-11-08
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-04 | Moderna | |
| 2 | 2021-04-01 | Moderna | |
| 3 | 2021-11-05 | Moderna | Flu |
Call center
3 call center cases
3 successful
Free text
Release 5 — day 14, dose 1
Symptoms: Covid-arm symptoms spread down my arm to the elbow and around the front of the muscle and to the back. Extreme itchiness, fatigue and body aches. Started letting up yesterday. Arm still red. Steroid cream,& Benedryl
Release 7 — day 14, dose 2
Symptoms: Red itchy swollen upper arm
Healthcare visit (other): Used medication from a previous visit
Release 11 — 12 months, dose 2
Symptoms: Had a cold and laryngitis in February. Couldn't talk. So couldn't do my job
Release 12 — 12 months, dose 3
Symptoms: Giant hiatel hernia,extreme anemia, pulmonary embolisms
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 | Self-medication | ✓ | ✓ | ✓ |
| SD | Anaemia | · | · | ✓ |
| SD | Erythema | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Hiatus hernia | · | · | ✓ |
| SD | Immunisation reaction | ✓ | ✓ | ✓ |
| SD | Impaired work ability | · | · | ✓ |
| SD | Laryngitis | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Peripheral swelling | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Pulmonary embolism | · | · | ✓ |
| SD | Speech disorder | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release