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5CA-10124-16903

2 vaccinations 9 coded responses 16 check-ins 9 free-text entries 0 call cases
Sex
Female
Age at first dose
46-50
ZIP prefix
925 / CA
Registered
2021-03-05
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-01
    Dose 1 — Moderna
  2. 2021-03-05
    Registered in v-safe
  3. 2021-03-05
    Dose 2 — Moderna
  4. 2021-03-05
    Health check-in — day 0, dose 2
    Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  5. 2021-03-06
    Survey response — days 1–6 daily, dose 2
    MedDRA: Feeling abnormal — Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Free text: Brain fog
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-03-07
    Survey response — days 1–6 daily, dose 2
    MedDRA: Axillary pain — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Free text: Pain in the armpit
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-03-08
    Survey response — days 1–6 daily, dose 2
    MedDRA: Lymph node pain — Feeling: Good · Site: Pain · Be unable to do your normal daily activities
    Free text: Intense pain in lymph node/armpit area on injection arm
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-03-09
    Survey response — days 1–6 daily, dose 2
    MedDRA: Lymphadenopathy, Pruritus, Tinnitus — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities
    Free text: Swollen lymph nodes in armpit and neck above collarbone area. High pitched ringing in left ear. Face feels slightly tingly and itchy.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-03-10
    Survey response — days 1–6 daily, dose 2
    MedDRA: Dizziness, Pruritus — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities
    Free text: Itching on scalp, face, and arms. Dizziness.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-03-11
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  11. 2021-03-12
    Health check-in — day 7, dose 2
    Feeling: Good · Site: Itching · None
    Adult check-in
  12. 2021-03-19
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-03-26
    Survey response — day 21, dose 2
    MedDRA: Fatigue — Feeling: Good · Be unable to work
    Free text: Periodic periods of extreme fatigue
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-04-02
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-04-09
    Survey response — day 35, dose 2
    MedDRA: Fatigue — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities
    Free text: Periodic extreme and sudden fatigue
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-04-16
    Survey response — day 42, dose 2
    MedDRA: Arthralgia, Pain in extremity — Feeling: Good · Be unable to do your normal daily activities
    Free text: Severe pain in hips and legs, especially at night
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-06-04
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-09-05
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  19. 2022-03-05
    Survey response — 12 months, dose 2
    MedDRA: Fatigue, Increased upper airway secretion — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Unusual fatigue and throat mucus
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-02-01Moderna
22021-03-05Moderna

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-06

Systemic reaction (other): Brain fog

2021-03-07

Systemic reaction (other): Pain in the armpit

2021-03-08

Systemic reaction (other): Intense pain in lymph node/armpit area on injection arm

2021-03-09

Systemic reaction (other): Swollen lymph nodes in armpit and neck above collarbone area. High pitched ringing in left ear. Face feels slightly tingly and itchy.

2021-03-10

Systemic reaction (other): Itching on scalp, face, and arms. Dizziness.

Release 6 — day 21, dose 2

2021-03-26

Symptoms: Periodic periods of extreme fatigue

Release 7 — day 35, dose 2

2021-04-09

Symptoms: Periodic extreme and sudden fatigue

Release 7 — day 42, dose 2

2021-04-16

Symptoms: Severe pain in hips and legs, especially at night

Release 11 — 12 months, dose 2

2022-03-05

Symptoms: Unusual fatigue and throat mucus

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

FieldPreferred term2021-092023-042024-11
SDArthralgia ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDIncreased upper airway secretion · · ✓
SDPain in extremity ✓ ✓ ✓
SROAxillary pain ✓ ✓ ✓
SRODizziness ✓ ✓ ✓
SROFeeling abnormal ✓ ✓ ✓
SROLymph node pain ✓ ✓ ✓
SROLymphadenopathy ✓ ✓ ✓
SROPruritus ✓ ✓ ✓
SROTinnitus ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release