4WB-13235-15914
4 vaccinations
8 coded responses
51 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 600 / IL
- Registered
- 2021-02-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-27
Registered in v-safe
-
2021-02-27
Dose 1 — Moderna
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-04
-
2021-03-05
Survey response — days 1–6 daily, dose 1MedDRA: Flushing — Feeling: Good · Fatigue or tirednessFree text: Flushing, but it's likely due to receiving IVIG infusion yesterday.gMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-06
Survey response — day 7, dose 1MedDRA: Immunoglobulin therapy — Feeling: Good · Fatigue or tirednessFree text: This may be symptom post-IVIG infusion on ThursdayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-13
Survey response — day 14, dose 1MedDRA: Fatigue, Feeling abnormal, Vaccination site erythema, Vaccination site pain, Vaccination site pruritus — Feeling: Good · Be unable to do your normal daily activitiesFree text: On days 10-13 days after the vaccination I had redness, itching and soreness around vaccine site (more than after vaccine), plus fatigue that forced me to sleep several hours 1 day, and several hours of brain fog. All have now disappeared.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-20
-
2021-03-27
Dose 2 — Moderna
- 2021-03-27
-
2021-03-28
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-29
- 2021-03-30
- 2021-03-31
- 2021-04-01
- 2021-04-02
- 2021-04-03
- 2021-04-10
-
2021-04-17
Survey response — day 21, dose 2MedDRA: Arthralgia, Burning sensation, Myalgia — Feeling: GoodFree text: Muscle and joint aches, burning sensation on forearm and shins.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-24
Survey response — day 28, dose 2MedDRA: Abdominal discomfort, Arthralgia, Fatigue, Myalgia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Some fatigue, achy muscles/joints, upset stomachMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-01
- 2021-05-08
- 2021-06-26
- 2021-09-25
-
2021-11-08
Dose 3 — Moderna
-
2021-11-09
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-11-11
- 2021-11-12
- 2021-11-13
- 2021-11-14
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2021-12-14
- 2021-12-20
- 2022-02-07
-
2022-04-20
Dose 4 — Moderna
- 2022-04-20
-
2022-04-21
Survey response — days 1–6 daily, dose 4MedDRA: Body temperature decreased — Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: My normal temperature is 96.7 so 97.6 was lowgrade for meMedDRA releases: 2024-11 · check-in free text available
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2022-04-22
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Redness, Swelling, Itching · NoneAdult check-in
-
2022-04-23
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2022-04-24
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2022-04-25
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Itching · Fatigue or tirednessAdult check-in
- 2022-04-26
- 2022-04-27
-
2022-05-04
Survey response — day 14, dose 4MedDRA: Axillary pain, Fatigue, Myalgia — Feeling: Good · Be unable to do your normal daily activitiesFree text: Intermitent mild to moderate fatigue and muscle aches almost daily. 2 days (not today) of underarm achinessMedDRA releases: 2024-11 · check-in free text available
- 2022-05-11
- 2022-05-18
- 2022-05-25
- 2022-06-02
-
2023-04-20
Survey response — 12 months, dose 4MedDRA: Anxiety, Mobility decreased, Muscle disorder, Nervous system disorder, Neuralgia, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
-
2023-04-20
Report sent to call center — 12 months, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2023-04-21
-
2023-04-24
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-27 | Moderna | |
| 2 | 2021-03-27 | Moderna | |
| 3 | 2021-11-08 | Moderna | No |
| 4 | 2022-04-20 | Moderna | No |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Flushing, but it's likely due to receiving IVIG infusion yesterday.g
Release 5 — day 7, dose 1
Systemic reaction (other): This may be symptom post-IVIG infusion on Thursday
Release 5 — day 14, dose 1
Symptoms: On days 10-13 days after the vaccination I had redness, itching and soreness around vaccine site (more than after vaccine), plus fatigue that forced me to sleep several hours 1 day, and several hours of brain fog. All have now disappeared.
Release 7 — day 21, dose 2
Symptoms: Muscle and joint aches, burning sensation on forearm and shins.
Release 7 — day 28, dose 2
Symptoms: Some fatigue, achy muscles/joints, upset stomach
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): My normal temperature is 96.7 so 97.6 was lowgrade for me
Release 11 — day 14, dose 4
Symptoms: Intermitent mild to moderate fatigue and muscle aches almost daily. 2 days (not today) of underarm achiness
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 | Office visit | · | · | ✓ |
| SD | Abdominal discomfort | ✓ | ✓ | ✓ |
| SD | Anxiety | · | · | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Axillary pain | · | · | ✓ |
| SD | Burning sensation | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Feeling abnormal | ✓ | ✓ | ✓ |
| SD | Mobility decreased | · | · | ✓ |
| SD | Muscle disorder | · | · | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Nervous system disorder | · | · | ✓ |
| SD | Neuralgia | · | · | ✓ |
| SD | Vaccination site erythema | ✓ | ✓ | ✓ |
| SD | Vaccination site pain | ✓ | ✓ | ✓ |
| SD | Vaccination site pruritus | ✓ | ✓ | ✓ |
| SRO | Body temperature decreased | · | · | ✓ |
| SRO | Flushing | ✓ | ✓ | ✓ |
| SRO | Immunoglobulin therapy | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release