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4T7-26991-31018

2 vaccinations 8 coded responses 22 check-ins 8 free-text entries 3 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
801 / CO
Registered
2021-01-26
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-26
    Registered in v-safe
  2. 2021-01-26
    Dose 1 — Moderna
  3. 2021-01-26
    Health check-in — day 0, dose 1
    Feeling: Good · Fatigue or tiredness, Nausea
    Adult check-in
  4. 2021-01-27
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  5. 2021-01-28
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  6. 2021-01-29
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-01-30
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-01-31
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-02-01
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-02-02
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  11. 2021-02-09
    Survey response — day 14, dose 1
    MedDRA: Injection site erythema, Injection site pruritus — Feeling: Good
    Free text: On Feb 3, 4, &5 I had redness and itching at injection site. That has since resolved.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-02-16
    Survey response — day 21, dose 1
    MedDRA: Headache, Loss of personal independence in daily activities, Neck pain, Pre-existing disease — Feeling: Fair
    Free text: Neck pain and bad headache for 2 days. I have a history of frequent headaches but this started in my neck. I did take a muscle relaxant and used heat. Switched to ice today and am improving. I am retired so no job, but unable to do a few chores.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-02-23
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  14. 2021-02-26
    Dose 2 — Moderna
  15. 2021-03-02
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness, Itching · Joint pains, Fatigue or tiredness
    Adult check-in
  16. 2021-03-03
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Itching · Joint pains, Fatigue or tiredness
    Adult check-in
  17. 2021-03-04
    Survey response — days 1–6 daily, dose 2
    MedDRA: Adverse reaction — Feeling: Good · Site: Redness · Headache, Fatigue or tiredness
    Free text: Used topical hydrocortisone on arm last nite. Much improved today
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-03-05
    Survey response — day 7, dose 2
    MedDRA: Cerebrovascular accident, Emergency care, Hospitalisation, Visual impairment — Feeling: Fair · Site: Pain · Headache · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization
    Free text: Systemic reaction (other): I am in the hospital. I had a stroke last nite. Only vision affected. Bleed NOT clot. · Healthcare visit (other): ER first then admitted
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  19. 2021-03-05
    Report sent to call center — day 7, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  20. 2021-03-12
    Survey response — day 14, dose 2
    MedDRA: Cerebral haemorrhage — Feeling: Fair · Get care from a doctor or other healthcare professional · Hospitalization
    Free text: Ive been discharged from the hospital and begun OT vision therapy. Took 1 week of Kepra 500 mg BID. Last dose this AM. Brain bleed F/U MRI in 6 wks
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-03-12
    Report sent to call center — day 14, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  22. 2021-03-19
    Health check-in — day 21, dose 2
    Feeling: Fair
    Adult check-in
  23. 2021-03-26
    Survey response — day 28, dose 2
    MedDRA: Cerebrovascular accident, Hospitalisation, Pruritus, SARS-CoV-2 test negative — Feeling: Fair
    Free text: Wide spread intermittent itching on arms, legs, face, neck, back, n abdomen WITHOUT rash or redness. Did have negative covid test on 3/05/2021 upon admission to hospital for stroke.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  24. 2021-04-02
    Health check-in — day 35, dose 2
    Feeling: Fair
    Adult check-in
  25. 2021-04-09
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-05-28
    Survey response — 3 months, dose 2
    MedDRA: Headache — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Frequent severe headaches
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  27. 2021-08-27
    Survey response — 6 months, dose 2
    MedDRA: Arthralgia, Asthenia, Headache, Injury, Joint range of motion decreased, Loss of personal independence in daily activities, Pain in extremity, Physiotherapy — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Symptoms: Frequent severe headaches some lasting 4 days. Left shoulder pain unrelated to injury which is now progressive with pain in my arm. Some limitation in strength and range of motion that somewhat interferes with daily activities. · Healthcare visit (other): Physical therapy
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  28. 2021-08-27
    Report sent to call center — 6 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  29. 2021-08-31
  30. 2021-09-01
  31. 2021-09-01
    Call successful
    Completed over the phone

Vaccinations

DoseDateManufacturerCo-administered
12021-01-26Moderna
22021-02-26Moderna

Call center

3 call center cases

3 successful

VAERS report filed, before or during a call: 3

See the call center timeline

Free text

Release 3 — day 14, dose 1

2021-02-09

Symptoms: On Feb 3, 4, &5 I had redness and itching at injection site. That has since resolved.

Release 4 — day 21, dose 1

2021-02-16

Symptoms: Neck pain and bad headache for 2 days. I have a history of frequent headaches but this started in my neck. I did take a muscle relaxant and used heat. Switched to ice today and am improving. I am retired so no job, but unable to do a few chores.

Release 5 — days 1–6 daily, dose 2

2021-03-04

Systemic reaction (other): Used topical hydrocortisone on arm last nite. Much improved today

Release 5 — day 7, dose 2

2021-03-05

Systemic reaction (other): I am in the hospital. I had a stroke last nite. Only vision affected. Bleed NOT clot.
Healthcare visit (other): ER first then admitted

Release 5 — day 14, dose 2

2021-03-12

Symptoms: Ive been discharged from the hospital and begun OT vision therapy. Took 1 week of Kepra 500 mg BID. Last dose this AM. Brain bleed F/U MRI in 6 wks

Release 6 — day 28, dose 2

2021-03-26

Symptoms: Wide spread intermittent itching on arms, legs, face, neck, back, n abdomen WITHOUT rash or redness. Did have negative covid test on 3/05/2021 upon admission to hospital for stroke.

Release 8 — 3 months, dose 2

2021-05-28

Symptoms: Frequent severe headaches

Release 9 — 6 months, dose 2

2021-08-27

Symptoms: Frequent severe headaches some lasting 4 days. Left shoulder pain unrelated to injury which is now progressive with pain in my arm. Some limitation in strength and range of motion that somewhat interferes with daily activities.
Healthcare visit (other): Physical therapy

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

FieldPreferred term2021-092023-042024-11
HCVOEmergency care ✓ ✓ ✓
HCVOHospitalisation ✓ ✓ ✓
HCVOPhysiotherapy ✓ · ✓
SDArthralgia ✓ · ✓
SDAsthenia ✓ · ✓
SDCerebral haemorrhage ✓ ✓ ✓
SDCerebrovascular accident ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDHospitalisation ✓ ✓ ✓
SDInjection site erythema ✓ ✓ ✓
SDInjection site pruritus ✓ ✓ ✓
SDInjury ✓ · ✓
SDJoint range of motion decreased ✓ · ✓
SDLoss of personal independence in daily activities ✓ ✓ ✓
SDNeck pain ✓ ✓ ✓
SDPain in extremity ✓ · ✓
SDPre-existing disease ✓ ✓ ✓
SDPruritus ✓ ✓ ✓
SDSARS-CoV-2 test negative ✓ ✓ ✓
SROAdverse reaction ✓ ✓ ✓
SROCerebrovascular accident ✓ ✓ ✓
SROVisual impairment ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release