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
-
2021-01-26
Registered in v-safe
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2021-01-26
Dose 1 — Moderna
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
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2021-02-09
Survey response — day 14, dose 1MedDRA: Injection site erythema, Injection site pruritus — Feeling: GoodFree 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
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2021-02-16
Survey response — day 21, dose 1MedDRA: Headache, Loss of personal independence in daily activities, Neck pain, Pre-existing disease — Feeling: FairFree 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
- 2021-02-23
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2021-02-26
Dose 2 — Moderna
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2021-03-02
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · Joint pains, Fatigue or tirednessAdult check-in
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2021-03-03
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Itching · Joint pains, Fatigue or tirednessAdult check-in
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2021-03-04
Survey response — days 1–6 daily, dose 2MedDRA: Adverse reaction — Feeling: Good · Site: Redness · Headache, Fatigue or tirednessFree text: Used topical hydrocortisone on arm last nite. Much improved todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-05
Survey response — day 7, dose 2MedDRA: 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, HospitalizationFree 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 admittedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-05
Report sent to call center — day 7, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-03-12
Survey response — day 14, dose 2MedDRA: Cerebral haemorrhage — Feeling: Fair · Get care from a doctor or other healthcare professional · HospitalizationFree 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 wksMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-12
Report sent to call center — day 14, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-19
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2021-03-26
Survey response — day 28, dose 2MedDRA: Cerebrovascular accident, Hospitalisation, Pruritus, SARS-CoV-2 test negative — Feeling: FairFree 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
- 2021-04-02
- 2021-04-09
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2021-05-28
Survey response — 3 months, dose 2MedDRA: Headache — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Frequent severe headachesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-08-27
Survey response — 6 months, dose 2MedDRA: 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 visitFree 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 therapyMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-27
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)
- 2021-08-31
- 2021-09-01
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2021-09-01
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-26 | Moderna | |
| 2 | 2021-02-26 | Moderna |
Call center
3 call center cases
3 successful
VAERS report filed, before or during a call: 3
Free text
Release 3 — day 14, dose 1
Symptoms: On Feb 3, 4, &5 I had redness and itching at injection site. That has since resolved.
Release 4 — day 21, dose 1
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
Systemic reaction (other): Used topical hydrocortisone on arm last nite. Much improved today
Release 5 — day 7, dose 2
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
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
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
Symptoms: Frequent severe headaches
Release 9 — 6 months, dose 2
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Emergency care | ✓ | ✓ | ✓ |
| HCVO | Hospitalisation | ✓ | ✓ | ✓ |
| HCVO | Physiotherapy | ✓ | · | ✓ |
| SD | Arthralgia | ✓ | · | ✓ |
| SD | Asthenia | ✓ | · | ✓ |
| SD | Cerebral haemorrhage | ✓ | ✓ | ✓ |
| SD | Cerebrovascular accident | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Hospitalisation | ✓ | ✓ | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injury | ✓ | · | ✓ |
| SD | Joint range of motion decreased | ✓ | · | ✓ |
| SD | Loss of personal independence in daily activities | ✓ | ✓ | ✓ |
| SD | Neck pain | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Cerebrovascular accident | ✓ | ✓ | ✓ |
| SRO | Visual impairment | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release