4X5-28113-17918
5 vaccinations
7 coded responses
34 check-ins
7 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 453 / OH
- Registered
- 2021-01-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-28
Registered in v-safe
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2021-01-28
Dose 1 — Moderna
- 2021-01-28
- 2021-01-29
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-11
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2021-02-18
Survey response — day 21, dose 1MedDRA: Hospitalisation, Thyroid mass — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: I dont believe this is connected to corona virus, but I have gotten notice from my family doctor that a recent scan I had revealed nodules on my thyroid. At this moment I am planning on having an ultrasound to find out what the nodules are. · Healthcare visit (other): Ultrasound test done in hospital.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-18
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-02-25
Dose 2 — Moderna
- 2021-02-25
-
2021-02-26
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
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2021-03-04
Health check-in — day 7, dose 2Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-03-11
- 2021-03-18
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2021-03-25
Survey response — day 28, dose 2MedDRA: Fatigue, Feeling cold — Feeling: FairFree text: Not sure this is related to immunization, though. Feeling very cold and tired just as though I was coming down with the flu.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-01
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2021-04-10
Survey response — day 42, dose 2MedDRA: Arthralgia, Pain in extremity — Feeling: FairFree text: Pain in upper shoulder with particular pain in upper arm especially in upper arm joint.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-27
Survey response — 3 months, dose 2MedDRA: Bone pain, Medical counselling, Self-medication, Spinal pain — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Since beginning of April I have experienced extreme pain from bone spur(s) in C6, C7 area of spine resulting in only one or two hours of sleep a night. Meds such as ibuprophen or Bauer extra strength only go so far. No COVID illness, though. · Healthcare visit (other): Call to doctors office for prescription.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-27
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-16
- 2021-08-26
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2021-11-04
Dose 3 — Moderna
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2022-02-25
Survey response — 12 months, dose 2MedDRA: Exostosis, Office visit, Pain, Pain in extremity — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Dealing with extreme pain in upper left side of body down to fingers probably due to diagnosed bone spur in C6, C7 spine area. No symptoms of Covid-19 as of this date. · Healthcare visit (other): Office visitMedDRA releases: 2024-11 · check-in free text available
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2022-02-25
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2022-03-01
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2022-04-07
Dose 4 — Moderna
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2022-04-12
Dose 5 — Moderna
- 2022-04-28
- 2022-05-05
- 2022-05-12
- 2022-05-13
- 2022-05-17
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2022-05-25
Survey response — day 42, dose 5MedDRA: Pre-existing disease, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Non-Covid related problems with pain-causing bone spur in neck area and problem with pain throughout right leg. · Healthcare visit (other): Getting an EMG through local hospital.MedDRA releases: 2024-11 · check-in free text available
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2022-05-25
Report sent to call center — day 42, dose 5Get care from a doctor or other healthcare professional1 call case(s)
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2022-05-25
Call successfulDoes not wish to fill out VAERS report
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2022-05-25
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-07-12
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2022-10-11
Survey response — 6 months, dose 5MedDRA: Arthralgia, Joint instability, Osteoporosis — Feeling: FairFree text: Osteoporosis in hip joint. Pain throughout leg starting where leg joins aforementioned hip. Buckling knee and ankle at various times as I walk.MedDRA releases: 2024-11 · check-in free text available
- 2023-04-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-28 | Moderna | |
| 2 | 2021-02-25 | Moderna | |
| 3 | 2021-11-04 | Moderna | No |
| 4 | 2022-04-07 | Moderna | No |
| 5 | 2022-04-12 | Moderna | No |
Call center
4 call center cases
4 successful
Free text
Release 4 — day 21, dose 1
Symptoms: I dont believe this is connected to corona virus, but I have gotten notice from my family doctor that a recent scan I had revealed nodules on my thyroid. At this moment I am planning on having an ultrasound to find out what the nodules are.
Healthcare visit (other): Ultrasound test done in hospital.
Release 6 — day 28, dose 2
Symptoms: Not sure this is related to immunization, though. Feeling very cold and tired just as though I was coming down with the flu.
Release 7 — day 42, dose 2
Symptoms: Pain in upper shoulder with particular pain in upper arm especially in upper arm joint.
Release 8 — 3 months, dose 2
Symptoms: Since beginning of April I have experienced extreme pain from bone spur(s) in C6, C7 area of spine resulting in only one or two hours of sleep a night. Meds such as ibuprophen or Bauer extra strength only go so far. No COVID illness, though.
Healthcare visit (other): Call to doctors office for prescription.
Release 11 — 12 months, dose 2
Symptoms: Dealing with extreme pain in upper left side of body down to fingers probably due to diagnosed bone spur in C6, C7 spine area. No symptoms of Covid-19 as of this date.
Healthcare visit (other): Office visit
Release 11 — day 42, dose 5
Symptoms: Non-Covid related problems with pain-causing bone spur in neck area and problem with pain throughout right leg.
Healthcare visit (other): Getting an EMG through local hospital.
Release 12 — 6 months, dose 5
Symptoms: Osteoporosis in hip joint. Pain throughout leg starting where leg joins aforementioned hip. Buckling knee and ankle at various times as I walk.
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 | Hospitalisation | ✓ | ✓ | ✓ |
| HCVO | Medical counselling | ✓ | ✓ | ✓ |
| HCVO | Office visit | · | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Bone pain | ✓ | ✓ | ✓ |
| SD | Exostosis | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Feeling cold | ✓ | ✓ | ✓ |
| SD | Joint instability | · | · | ✓ |
| SD | Osteoporosis | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Self-medication | ✓ | ✓ | ✓ |
| SD | Spinal pain | ✓ | ✓ | ✓ |
| SD | Thyroid mass | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release