579-22897-52148
3 vaccinations
8 coded responses
26 check-ins
8 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 950 / CA
- Registered
- 2021-02-18
- Relationship
- Self
- Race
- Other
- Ethnicity
- Hispanic or Latino
Timeline
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2021-02-17
Dose 1 — Moderna
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2021-02-18
Registered in v-safe
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2021-02-19
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
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2021-02-20
Survey response — days 1–6 daily, dose 1MedDRA: Swelling — Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Its swollenMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-21
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Redness, Swelling, Itching · Headache, Fatigue or tirednessAdult check-in
- 2021-02-22
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2021-02-23
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: Fair · Fatigue or tirednessFree text: Lightheaded dizzy.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-24
Health check-in — day 7, dose 1Feeling: Fair · Site: Itching · Headache, Fatigue or tirednessAdult check-in
- 2021-03-04
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2021-03-10
Survey response — day 21, dose 1MedDRA: Fear, Feeling abnormal, Memory impairment — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Brain fog, same day I got up to get something I forgot what I was getting same day as going out to my car forgot what I was going. I want this to go away. My next shot is March 17/21. Im scared. I feel like I Have Dementia very bad memory.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-17
Dose 2 — Moderna
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2021-03-19
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-03-20
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-03-21
Survey response — days 1–6 daily, dose 2MedDRA: Back pain — Feeling: Good · Site: Itching · Headache, Fatigue or tirednessFree text: Lower back painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-24
Survey response — day 7, dose 2MedDRA: Amnesia, Unevaluable event — Feeling: Poor · Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Systemic reaction (other): Why dont you ask about short term memory loss its been two months already and it has not gone away. Why doesnt anybody tell me whats going on? I have short term memory since Ive had this shot its horrible. Thats my whole complaint. · Healthcare visit (other): I have short term memory loss when is it going to go away? You have no questions for that to pick on any of your questions that youre asking. This is not new a lot of people have this. Theres just nowhere to put it on this survey that youre sending meMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-24
Report sent to call center — day 7, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-31
- 2021-04-08
- 2021-04-16
- 2021-04-21
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2021-04-28
Survey response — day 42, dose 2MedDRA: Amnesia, Brain fog — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Forgetful, memory loss, brain fog.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-28
Report sent to call center — day 42, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-16
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2021-11-01
Dose 3 — Pfizer-BioNTechCo-administered: Other
- 2021-11-02
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
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2021-12-06
Survey response — day 35, dose 3MedDRA: Pain, Pain in extremity — Feeling: FairFree text: I haven't mentioned it before because I thought it would go away but the injection that I got on my left arm the last one Booster shot my arm still hurt even when I go side to side in the bed. Or try to put a top on.MedDRA releases: 2024-11 · check-in free text available
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2021-12-15
Survey response — day 42, dose 3MedDRA: Medical counselling, Pain, Pain in extremity, Telemedicine — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Both arms still have pain. I spoke with my Dr. today. I'm making appt to c him. · Healthcare visit (other): I had a zoom meeting & I told him it hurt's I will c himMedDRA releases: 2024-11 · check-in free text available
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2021-12-15
Report sent to call center — day 42, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2021-12-16
- 2022-01-31
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-17 | Moderna | |
| 2 | 2021-03-17 | Moderna | |
| 3 | 2021-11-01 | Pfizer-BioNTech | Other |
Call center
3 call center cases
3 unsuccessful
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Its swollen
Systemic reaction (other): Lightheaded dizzy.
Release 5 — day 21, dose 1
Symptoms: Brain fog, same day I got up to get something I forgot what I was getting same day as going out to my car forgot what I was going. I want this to go away. My next shot is March 17/21. Im scared. I feel like I Have Dementia very bad memory.
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Lower back pain
Release 6 — day 7, dose 2
Systemic reaction (other): Why dont you ask about short term memory loss its been two months already and it has not gone away. Why doesnt anybody tell me whats going on? I have short term memory since Ive had this shot its horrible. Thats my whole complaint.
Healthcare visit (other): I have short term memory loss when is it going to go away? You have no questions for that to pick on any of your questions that youre asking. This is not new a lot of people have this. Theres just nowhere to put it on this survey that youre sending me
Release 8 — day 42, dose 2
Symptoms: Forgetful, memory loss, brain fog.
Release 10 — day 35, dose 3
Symptoms: I haven't mentioned it before because I thought it would go away but the injection that I got on my left arm the last one Booster shot my arm still hurt even when I go side to side in the bed. Or try to put a top on.
Release 10 — day 42, dose 3
Symptoms: Both arms still have pain. I spoke with my Dr. today. I'm making appt to c him.
Healthcare visit (other): I had a zoom meeting & I told him it hurt's I will c him
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 | Pain | · | · | ✓ |
| HCVO | Telemedicine | · | · | ✓ |
| HCVO | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Amnesia | ✓ | ✓ | ✓ |
| SD | Brain fog | ✓ | ✓ | ✓ |
| SD | Fear | ✓ | ✓ | ✓ |
| SD | Feeling abnormal | ✓ | ✓ | ✓ |
| SD | Medical counselling | · | · | ✓ |
| SD | Memory impairment | ✓ | ✓ | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SRO | Amnesia | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Swelling | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release