4Y9-30877-12459
5 vaccinations
4 coded responses
31 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 435 / OH
- Registered
- 2021-03-07
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-07
Registered in v-safe
-
2021-03-10
Dose 1 — Moderna
-
2021-03-20
Survey response — day 7, dose 1MedDRA: Fatigue, Malaise, Mobility decreased, Pain in extremity, Peripheral swelling — Feeling: Good · Site: Pain, Redness, Swelling, ItchingFree text: The pain and swelling in my arm was intense a couple days ago. Eight hours after the shot I couldnt use my arm and had to go to bed due to fatigue and the feeling that I was getting sick. Felt that way two days. I was fine and then a week later the swelling started.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
- 2021-03-31
-
2021-04-07
Dose 2 — Moderna
- 2021-04-07
-
2021-04-08
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-09
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-10
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue, Self-medication — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Had to lay down and nap about 90 minutes. Taking Tylenol.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-11
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling, Itching · NoneAdult check-in
-
2021-04-12
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling, Itching · NoneAdult check-in
-
2021-04-13
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling, Itching · NoneAdult check-in
- 2021-04-14
- 2021-04-21
- 2021-04-28
- 2021-05-05
- 2021-05-12
- 2021-05-19
- 2021-07-07
- 2021-10-06
-
2021-11-12
Dose 3 — Moderna
- 2022-04-07
-
2022-05-25
Dose 4 — Moderna
-
2022-10-03
Dose 5 — Moderna
-
2022-10-06
Survey response — days 1–6 daily, dose 5MedDRA: Fatigue, Pain, Reaction to previous exposure to any vaccine — Feeling: Good · Site: Pain, SwellingFree text: The day I received my shot I became very fatigued and had all over body pain several hours after the shot. It lingered throughout the next day, but did not keep me in bed. The previous shots put me in bed. This injection had lighter side effects.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-07
- 2022-10-08
- 2022-10-09
- 2022-10-10
- 2022-10-17
- 2022-10-24
- 2022-10-31
- 2022-11-07
- 2022-11-14
- 2023-01-02
-
2023-04-04
Survey response — 6 months, dose 5MedDRA: Altered state of consciousness, Amnesia, Brain fog, Confusional state, Fatigue, Loss of consciousness — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11
-
2023-04-04
Report sent to call center — 6 months, dose 5Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2023-04-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-10 | Moderna | |
| 2 | 2021-04-07 | Moderna | |
| 3 | 2021-11-12 | Moderna | No |
| 4 | 2022-05-25 | Moderna | No |
| 5 | 2022-10-03 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 6 — day 7, dose 1
Systemic reaction (other): The pain and swelling in my arm was intense a couple days ago. Eight hours after the shot I couldnt use my arm and had to go to bed due to fatigue and the feeling that I was getting sick. Felt that way two days. I was fine and then a week later the swelling started.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Had to lay down and nap about 90 minutes. Taking Tylenol.
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): The day I received my shot I became very fatigued and had all over body pain several hours after the shot. It lingered throughout the next day, but did not keep me in bed. The previous shots put me in bed. This injection had lighter side effects.
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 |
|---|---|---|---|---|
| SD | Altered state of consciousness | · | · | ✓ |
| SD | Amnesia | · | · | ✓ |
| SD | Brain fog | · | · | ✓ |
| SD | Confusional state | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Loss of consciousness | · | · | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Malaise | ✓ | ✓ | ✓ |
| SRO | Mobility decreased | ✓ | ✓ | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Peripheral swelling | ✓ | ✓ | ✓ |
| SRO | Reaction to previous exposure to any vaccine | · | · | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release