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4W4-17212-77155

5 vaccinations 11 coded responses 43 check-ins 10 free-text entries 2 call cases
Sex
Female
Age at first dose
51-55
ZIP prefix
454 / OH
Registered
2021-01-14
Relationship
Self
Race
Asian
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-14
    Registered in v-safe
  2. 2021-01-14
    Dose 1 — Moderna
  3. 2021-01-14
    Survey response — day 0, dose 1
    MedDRA: Injection site hypoaesthesia, Injection site induration — Feeling: Good · Site: Pain, Swelling · Headache, Muscle or body aches
    Free text: Bicep muscle, site of shot: hardness, numb
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-01-15
    Survey response — days 1–6 daily, dose 1
    MedDRA: Eye irritation, Ocular hyperaemia — Feeling: Good · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: Right eye became red and irritated
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-01-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Nausea
    Adult check-in
  6. 2021-01-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Redness, Swelling, Itching · Fatigue or tiredness
    Adult check-in
  7. 2021-01-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Swelling, Itching · Headache, Joint pains, Fatigue or tiredness
    Adult check-in
  8. 2021-01-21
    Survey response — day 7, dose 1
    MedDRA: Injection site mass, Injection site swelling, Medical counselling, Medical observation — Feeling: Good · Site: Redness, Swelling, Itching · Joint pains, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Systemic reaction (other): I had a nurse look at the injection site, because it has been swollen and hard for eight days now. We are worried that it might be cellulitis · Healthcare visit (other): Nurses and nurse practitioner
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-01-21
    Report sent to call center — day 7, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  10. 2021-01-29
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-02-06
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-02-11
    Dose 2 — Moderna
  13. 2021-02-12
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work
    Adult check-in
  14. 2021-02-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness
    Adult check-in
  15. 2021-02-14
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  16. 2021-02-15
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site warmth — Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness, Nausea
    Free text: I should have mentioned that the injection site has felt warm to the touch for the past five days.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-02-16
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea
    Adult check-in
  18. 2021-02-17
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  19. 2021-02-18
    Health check-in — day 7, dose 2
    Feeling: Good · Site: Pain, Swelling · Headache, Joint pains, Fatigue or tiredness
    Adult check-in
  20. 2021-02-25
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-03-04
    Survey response — day 21, dose 2
    MedDRA: Medical counselling, Neuropathy peripheral, Pain in extremity — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Pain in both feet, with neuropathy and the toes of the right foot. · Healthcare visit (other): Chiropractic care
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-03-04
    Report sent to call center — day 21, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  23. 2021-03-11
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-03-18
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-03-25
    Survey response — day 42, dose 2
    MedDRA: Asthma, Lung disorder — Feeling: Fair
    Free text: Asthma and constricted lungs, I believe due to tree pollen
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  26. 2021-03-30
  27. 2021-05-13
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-08-12
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  29. 2021-10-25
    Dose 3 — Moderna
  30. 2021-10-27
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain, Swelling · None
    Adult check-in
  31. 2021-10-28
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain, Swelling · None
    Adult check-in
  32. 2021-10-29
    Survey response — days 1–6 daily, dose 3
    MedDRA: Injection site erythema, Pyrexia — Feeling: Good · Site: Pain, Redness, Swelling
    Free text: I forgot to mention that I did feel feverish on 10/26/21. The injection site has been red 10/25- 10/29/21
    MedDRA releases: 2024-11 · check-in free text available
  33. 2021-10-30
    Survey response — days 1–6 daily, dose 3
    MedDRA: Injection site erythema, Injection site swelling, Pyrexia — Feeling: Good · Site: Pain, Redness, Swelling
    Free text: I forgot to report that I was feverish on 10/26/21. The injection site was red and swollen from 10/25- 10/30/21
    MedDRA releases: 2024-11 · check-in free text available
  34. 2021-10-31
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain, Swelling · None
    Adult check-in
  35. 2021-11-01
    Health check-in — day 7, dose 3
    Feeling: Good · Site: Pain, Swelling · None
    Adult check-in
  36. 2021-11-08
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  37. 2021-11-15
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  38. 2021-11-22
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  39. 2021-11-30
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  40. 2021-12-06
    Survey response — day 42, dose 3
    MedDRA: Ear discomfort — Feeling: Good
    Free text: My right ear has felt stuffy and like it's a little bit plugged up. No discharge. For five days. I never have ear infections, so I don't know what this is
    MedDRA releases: 2024-11 · check-in free text available
  41. 2022-01-24
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  42. 2022-03-30
    Dose 4 — Moderna
  43. 2022-04-25
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  44. 2022-09-05
    Dose 5 — Moderna
  45. 2022-09-14
    Survey response — day 7, dose 5
    MedDRA: Fatigue, Injection site swelling, Mobility decreased, Pain — Feeling: Good
    Free text: On day of vaccination and 4 days after, injection site was swollen. Difficult to raise that arm. The day after the shot, moderate fatigue and body aches on 09/06/2022
    MedDRA releases: 2024-11 · check-in free text available
  46. 2022-09-19
    Health check-in — day 14, dose 5
    Feeling: Good
    Adult check-in
  47. 2022-09-26
    Health check-in — day 21, dose 5
    Feeling: Good
    Adult check-in
  48. 2022-10-03
    Health check-in — day 28, dose 5
    Feeling: Good
    Adult check-in
  49. 2022-10-10
    Health check-in — day 35, dose 5
    Feeling: Good
    Adult check-in
  50. 2022-10-17
    Health check-in — day 42, dose 5
    Feeling: Good
    Adult check-in
  51. 2022-12-05
    Health check-in — 3 months, dose 5
    Feeling: Good
    Adult check-in
  52. 2023-03-08
    Survey response — 6 months, dose 5
    MedDRA: Bronchitis, Nasopharyngitis, SARS-CoV-2 test negative, Viral infection — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities
    MedDRA releases: 2024-11

Vaccinations

DoseDateManufacturerCo-administered
12021-01-14Moderna
22021-02-11Moderna
32021-10-25Moderna No
42022-03-30Moderna No
52022-09-05Moderna No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-14

Systemic reaction (other): Bicep muscle, site of shot: hardness, numb

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): Right eye became red and irritated

Release 2 — day 7, dose 1

2021-01-21

Systemic reaction (other): I had a nurse look at the injection site, because it has been swollen and hard for eight days now. We are worried that it might be cellulitis
Healthcare visit (other): Nurses and nurse practitioner

Release 4 — days 1–6 daily, dose 2

2021-02-15

Systemic reaction (other): I should have mentioned that the injection site has felt warm to the touch for the past five days.

Release 5 — day 21, dose 2

2021-03-04

Symptoms: Pain in both feet, with neuropathy and the toes of the right foot.
Healthcare visit (other): Chiropractic care

Release 6 — day 42, dose 2

2021-03-25

Symptoms: Asthma and constricted lungs, I believe due to tree pollen

Release 10 — days 1–6 daily, dose 3

2021-10-29

Systemic reaction (other): I forgot to mention that I did feel feverish on 10/26/21. The injection site has been red 10/25- 10/29/21

2021-10-30

Systemic reaction (other): I forgot to report that I was feverish on 10/26/21. The injection site was red and swollen from 10/25- 10/30/21

Release 10 — day 42, dose 3

2021-12-06

Symptoms: My right ear has felt stuffy and like it's a little bit plugged up. No discharge. For five days. I never have ear infections, so I don't know what this is

Release 12 — day 7, dose 5

2022-09-14

Systemic reaction (other): On day of vaccination and 4 days after, injection site was swollen. Difficult to raise that arm. The day after the shot, moderate fatigue and body aches on 09/06/2022

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
HCVOMedical counselling ✓ ✓ ✓
SDAsthma ✓ ✓ ✓
SDBronchitis · · ✓
SDEar discomfort · · ✓
SDLung disorder ✓ ✓ ✓
SDNasopharyngitis · · ✓
SDNeuropathy peripheral ✓ ✓ ✓
SDPain in extremity ✓ ✓ ✓
SDSARS-CoV-2 test negative · · ✓
SDViral infection · · ✓
SROEye irritation ✓ ✓ ✓
SROFatigue · · ✓
SROInjection site erythema · · ✓
SROInjection site hypoaesthesia ✓ ✓ ✓
SROInjection site induration ✓ ✓ ✓
SROInjection site mass ✓ ✓ ✓
SROInjection site swelling ✓ ✓ ✓
SROInjection site warmth ✓ ✓ ✓
SROMedical observation ✓ ✓ ✓
SROMobility decreased · · ✓
SROOcular hyperaemia ✓ ✓ ✓
SROPain · · ✓
SROPyrexia · · ✓

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

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