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4V3-26985-00611

1 vaccination 5 coded responses 7 check-ins 5 free-text entries 3 call cases
Sex
Female
Age at first dose
56-60
ZIP prefix
684 / NE
Registered
2021-05-04
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-04-28
    Dose 1 — Moderna
  2. 2021-05-04
    Registered in v-safe
  3. 2021-05-04
    Survey response — days 1–6 daily, dose 1
    MedDRA: Chest pain, Dizziness, Dyspnoea, Heart rate increased, Lymph node pain, Lymphadenopathy, Musculoskeletal pain, Pain, Pain in extremity, Palpitations, Tremor — Feeling: Poor · Site: Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · 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
    Free text: Swollen lymph nodes under my vaccinated arm with pain radiating down my arm, into my chest and along my left shoulder blade. Also dizzy and shakes. Elevated heart rate, palpitations and shortness of breath.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-05-04
    Report sent to call center — days 1–6 daily, dose 1
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  5. 2021-05-05
    Survey response — day 7, dose 1
    MedDRA: Chest pain, Cough, Fatigue, Lymphadenopathy, Pain, Pain in extremity, Pulmonary congestion, Sleep disorder, Wheezing — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Free text: Swollen lymph nodes under my left arm in which I was vaccinated. Pain disrupts sleep and radiates down my arm and into my chest. Congested lungs, coughing and wheezing, extreme fatigue
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-05-15
    Health check-in — day 14, dose 1
    Feeling: Fair
    Adult check-in
  7. 2021-05-19
    Survey response — day 21, dose 1
    MedDRA: Fatigue, Headache, Pain — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Very achey, headache, fatigue
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-06-09
    Health check-in — day 42, dose 1
    Feeling: Good
    Adult check-in
  9. 2021-10-27
    Survey response — 6 months, dose 1
    MedDRA: Asthma, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Asthma flare ups
    MedDRA releases: 2024-11 · check-in free text available
  10. 2021-10-27
    Report sent to call center — 6 months, dose 1
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  11. 2021-10-28
  12. 2022-04-28
    Survey response — 12 months, dose 1
    MedDRA: Arthralgia, Arthritis, Fatigue, Spondylitis — Feeling: Good · 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: Painful inflation in my hip, back, neck and most of my joints for a couple of weeks, along with fatigue.
    MedDRA releases: 2024-11 · check-in free text available
  13. 2022-04-28
    Report sent to call center — 12 months, dose 1
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  14. 2022-04-29
  15. 2022-05-02
  16. 2022-05-02

Vaccinations

DoseDateManufacturerCo-administered
12021-04-28Moderna

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 8 — days 1–6 daily, dose 1

2021-05-04

Systemic reaction (other): Swollen lymph nodes under my vaccinated arm with pain radiating down my arm, into my chest and along my left shoulder blade. Also dizzy and shakes. Elevated heart rate, palpitations and shortness of breath.

Release 8 — day 7, dose 1

2021-05-05

Systemic reaction (other): Swollen lymph nodes under my left arm in which I was vaccinated. Pain disrupts sleep and radiates down my arm and into my chest. Congested lungs, coughing and wheezing, extreme fatigue

Release 8 — day 21, dose 1

2021-05-19

Symptoms: Very achey, headache, fatigue

Release 10 — 6 months, dose 1

2021-10-27

Symptoms: Asthma flare ups

Release 11 — 12 months, dose 1

2022-04-28

Symptoms: Painful inflation in my hip, back, neck and most of my joints for a couple of weeks, along with fatigue.

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
SDArthralgia · · ✓
SDArthritis · · ✓
SDAsthma · · ✓
SDFatigue ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDPain ✓ ✓ ✓
SDPre-existing disease · · ✓
SDSpondylitis · · ✓
SROChest pain ✓ ✓ ✓
SROCough ✓ ✓ ✓
SRODizziness ✓ ✓ ✓
SRODyspnoea ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROHeart rate increased ✓ ✓ ✓
SROLymph node pain ✓ ✓ ✓
SROLymphadenopathy ✓ ✓ ✓
SROMusculoskeletal pain ✓ ✓ ✓
SROPain ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROPalpitations ✓ ✓ ✓
SROPulmonary congestion ✓ ✓ ✓
SROSleep disorder ✓ ✓ ✓
SROTremor ✓ ✓ ✓
SROWheezing ✓ ✓ ✓

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