57V-15542-08815
3 vaccinations
5 coded responses
31 check-ins
5 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 575 / SD
- Registered
- 2021-01-07
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-07
Registered in v-safe
-
2021-01-07
Dose 1 — Moderna
- 2021-01-07
-
2021-01-08
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-01-08
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Be unable to do your normal daily activities1 call case(s)
- 2021-01-09
- 2021-01-10
- 2021-01-11
- 2021-01-12
- 2021-01-13
-
2021-01-14
Survey response — day 7, dose 1MedDRA: Lymphadenopathy, Pain, Skin swelling, Tenderness, Throat irritation — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Extremely tender, puffy and sore with enlarged lymph nodes above clavicle. Mostly on side of injection but also a little sore and puffy on other side. Scratchy throat.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-14
Report sent to call center — day 7, dose 1Be unable to do your normal daily activities1 call case(s)
-
2021-01-21
Survey response — day 14, dose 1MedDRA: Arthralgia, Fatigue, Headache, Lymphadenopathy, Neck pain — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Swollen lymph supraclavicular area. Headache, fatigue, shoulder and neck achy.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-28
- 2021-02-04
-
2021-02-05
Dose 2 — Moderna
- 2021-02-11
- 2021-02-12
- 2021-02-19
- 2021-02-26
- 2021-03-05
- 2021-03-14
- 2021-03-19
- 2021-05-07
- 2021-08-06
-
2021-10-22
Dose 3 — Moderna
-
2021-10-25
Survey response — days 1–6 daily, dose 3MedDRA: Lymphadenopathy, Pain, Swelling — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Pain, great, swelling in the hollow above clavicle on and side as shot. Enlatged lymph.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-26
Survey response — days 1–6 daily, dose 3MedDRA: Back pain, Neck pain, Pain, Swelling — Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Pain and swelling in area above clavicle. Pain extends into traps and into neck. Pretty intense.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-10-29
- 2021-11-07
- 2021-11-12
- 2021-11-19
- 2021-11-26
-
2021-12-05
Survey response — day 42, dose 3MedDRA: Appendicectomy — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Probably unrelated but had an appendectomy.MedDRA releases: 2024-11 · check-in free text available
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2021-12-05
Report sent to call center — day 42, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · 1 call case(s)
-
2021-12-06
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-04-22
- 2022-10-24
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-07 | Moderna | |
| 2 | 2021-02-05 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
Call center
3 call center cases
1 successful · 2 priority 2/3 (triaged and no follow up)
Free text
Release 2 — day 7, dose 1
Systemic reaction (other): Extremely tender, puffy and sore with enlarged lymph nodes above clavicle. Mostly on side of injection but also a little sore and puffy on other side. Scratchy throat.
Release 2 — day 14, dose 1
Symptoms: Swollen lymph supraclavicular area. Headache, fatigue, shoulder and neck achy.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Pain, great, swelling in the hollow above clavicle on and side as shot. Enlatged lymph.
Systemic reaction (other): Pain and swelling in area above clavicle. Pain extends into traps and into neck. Pretty intense.
Release 10 — day 42, dose 3
Symptoms: Probably unrelated but had an appendectomy.
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 | Appendicectomy | · | · | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SD | Neck pain | ✓ | ✓ | ✓ |
| SRO | Back pain | · | · | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Neck pain | · | · | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Skin swelling | ✓ | ✓ | ✓ |
| SRO | Swelling | · | · | ✓ |
| SRO | Tenderness | ✓ | ✓ | ✓ |
| SRO | Throat irritation | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release