4Y4-25590-96423
5 vaccinations
10 coded responses
65 check-ins
9 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 300 / GA
- Registered
- 2021-01-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-14
Registered in v-safe
-
2021-01-14
Dose 1 — Moderna
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-20
- 2021-01-21
-
2021-01-28
Survey response — day 14, dose 1MedDRA: Pruritus, Skin warm, Urticaria — Feeling: GoodFree text: On 1/22/21 my arm started itching again, only moreso than the first time. There was a hard welt approximately 3 in diameter. It was warm to the touch. It all disappeared in about 48 hrs.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-04
- 2021-02-11
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2021-02-12
Dose 2 — Moderna
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2021-02-13
Survey response — days 1–6 daily, dose 2MedDRA: Nodule — Feeling: Good · Site: Pain, Swelling, Itching · Muscle or body achesFree text: It's more of a knot, than swelling.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-14
Survey response — days 1–6 daily, dose 2MedDRA: Nodule, Pruritus, Tenderness — Feeling: Good · Site: Pain, Swelling, Itching · Muscle or body achesFree text: The knot is getting smaller. The tenderness and itchiness are diminishing.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-15
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling, Itching · NoneAdult check-in
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2021-02-16
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: Good · Site: Pain, Swelling, Itching · Muscle or body achesFree text: There's actually no longer any pain, itching or swelling (knot) but, there's no option for that. Perhaps, you can add a question regarding the cessation of side effects.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-26
- 2021-03-05
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-05-14
- 2021-08-13
-
2021-09-08
Dose 3 — Moderna
- 2021-09-08
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2021-09-09
Survey response — days 1–6 daily, dose 3MedDRA: Arthritis, Asthenopia, Headache, Middle insomnia, Self-medication — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, NauseaFree text: The headache may have been triggered by eye strain. However, even after using Tylenol for arthritis last night and again today, it has not gone away. In fact, I was awakened by it in the middle of the night.MedDRA releases: 2024-11 · check-in free text available
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2021-09-10
Survey response — days 1–6 daily, dose 3MedDRA: Chills, Vertigo, Weight decreased — Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Severe chills. Vertigo. Lost 6 lbs. in water weight overnight.MedDRA releases: 2024-11 · check-in free text available
- 2021-09-11
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2021-09-12
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Swelling, Itching · NoneAdult check-in
- 2021-09-13
- 2021-09-14
- 2021-09-15
- 2021-09-23
- 2021-09-29
- 2021-10-06
- 2021-10-13
- 2021-10-20
- 2021-12-08
- 2022-03-09
-
2022-07-07
Dose 4 — Moderna
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2022-07-08
Survey response — days 1–6 daily, dose 4MedDRA: Death — Feeling: Good · Site: Pain, Swelling · HeadacheFree text: How do I report that my father has passed away so you stop sending me the V-Safe check-in for him? He was 95 and passed peacefully. It wasn't related to CoVid.MedDRA releases: 2024-11 · check-in free text available
- 2022-07-09
- 2022-07-11
- 2022-07-12
- 2022-07-13
- 2022-07-14
- 2022-07-21
- 2022-07-28
- 2022-08-04
- 2022-08-11
- 2022-08-18
-
2022-09-17
Dose 5 — ModernaCo-administered: Flu
- 2022-09-18
-
2022-09-19
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
-
2022-09-20
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2022-09-21
- 2022-09-22
-
2022-09-23
Survey response — days 1–6 daily, dose 5MedDRA: Unevaluable event — Feeling: Poor · Headache, Nausea, Diarrhea · Be unable to do your normal daily activitiesFree text: Rapid Testing negativeMedDRA releases: 2024-11 · check-in free text available
- 2022-09-24
- 2022-10-01
- 2022-10-08
- 2022-10-15
- 2022-10-22
- 2022-10-29
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2022-12-17
Survey response — 3 months, dose 5MedDRA: Postmenopausal haemorrhage — Feeling: GoodFree text: I'm in full menopause, and have been for years, yet now and then when I wipe after urinating, there's fresh blood. Like spotting just before your period starts on earnest.MedDRA releases: 2024-11 · check-in free text available
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2023-03-18
Survey response — 6 months, dose 5MedDRA: Hypersomnia, Influenza, Office visit, Productive cough, Pyrexia, SARS-CoV-2 test negative, Sinusitis, Sputum discoloured — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
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2023-03-18
Report sent to call center — 6 months, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2023-03-20
- 2023-03-22
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2023-03-22
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-14 | Moderna | |
| 2 | 2021-02-12 | Moderna | |
| 3 | 2021-09-08 | Moderna | No |
| 4 | 2022-07-07 | Moderna | No |
| 5 | 2022-09-17 | Moderna | Flu |
Call center
1 call center case
1 successful
Free text
Release 3 — day 14, dose 1
Symptoms: On 1/22/21 my arm started itching again, only moreso than the first time. There was a hard welt approximately 3 in diameter. It was warm to the touch. It all disappeared in about 48 hrs.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): It's more of a knot, than swelling.
Systemic reaction (other): The knot is getting smaller. The tenderness and itchiness are diminishing.
Systemic reaction (other): There's actually no longer any pain, itching or swelling (knot) but, there's no option for that. Perhaps, you can add a question regarding the cessation of side effects.
Release 9 — days 1–6 daily, dose 3
Systemic reaction (other): The headache may have been triggered by eye strain. However, even after using Tylenol for arthritis last night and again today, it has not gone away. In fact, I was awakened by it in the middle of the night.
Systemic reaction (other): Severe chills. Vertigo. Lost 6 lbs. in water weight overnight.
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): How do I report that my father has passed away so you stop sending me the V-Safe check-in for him? He was 95 and passed peacefully. It wasn't related to CoVid.
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Rapid Testing negative
Release 12 — 3 months, dose 5
Symptoms: I'm in full menopause, and have been for years, yet now and then when I wipe after urinating, there's fresh blood. Like spotting just before your period starts on earnest.
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 | Hypersomnia | · | · | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Postmenopausal haemorrhage | · | · | ✓ |
| SD | Productive cough | · | · | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Skin warm | ✓ | ✓ | ✓ |
| SD | Sputum discoloured | · | · | ✓ |
| SD | Urticaria | ✓ | ✓ | ✓ |
| SRO | Arthritis | · | · | ✓ |
| SRO | Asthenopia | · | · | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Death | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Middle insomnia | · | · | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Nodule | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Self-medication | · | · | ✓ |
| SRO | Tenderness | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
| SRO | Vertigo | · | · | ✓ |
| SRO | Weight decreased | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release