5E2-10661-96156
2 vaccinations
10 coded responses
17 check-ins
10 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 327 / FL
- Registered
- 2021-03-25
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-08
Dose 1 — Moderna
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2021-03-25
Registered in v-safe
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2021-03-25
Survey response — day 14, dose 1MedDRA: Diarrhoea, Fatigue, Feeling abnormal, Injection site rash, Pain, Pain in extremity, Peripheral swelling — Feeling: FairFree text: Arm rash in shot area is bigger; arm seems a bit swollen, and a bit achy and strange at times. Some body aches in different areas (did not have them before shot). Looser bowels than normal. Tiredness.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-29
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2021-04-05
Dose 2 — Moderna
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2021-04-06
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
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2021-04-07
Survey response — days 1–6 daily, dose 2MedDRA: Body temperature increased, Self-medication — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Temp suddenly spiked to almost 104 yesterday, so Ive been taking Tylenol since then.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-08
Survey response — days 1–6 daily, dose 2MedDRA: Asthenia, Self-medication — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesFree text: The temperature I reported is with Tylenol in my system. My energy levels are low.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-09
Survey response — days 1–6 daily, dose 2MedDRA: Body temperature increased, Self-medication — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: My normal body temp is in the 97 degree range. For me to have a 99.34 temp with Tylenol in my system means I m running a low grade fever.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-10
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue, Peripheral swelling — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Note: I am running roughly 2 degrees above my normal body temperature which is in the 97 range. I tire very easily. With the swelling in my arm, an indentation like a dimple from cellulite has formed.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-11
Survey response — days 1–6 daily, dose 2MedDRA: Rash — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: A dimple (reminiscent of cellulite) appeared in the swollen patch of rash on my arm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-12
Survey response — day 7, dose 2MedDRA: Unevaluable event — Feeling: Fair · Site: Redness, Swelling · Fever · DiarrheaFree text: A question..Is it ok that my temp gets into the 99 range when my normal body temp is in the 97 range?MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-19
- 2021-04-26
- 2021-05-03
- 2021-05-10
- 2021-05-17
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2021-07-05
Survey response — 3 months, dose 2MedDRA: Induration, Lymphadenopathy, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: I just noticed a hard, enlarged, non-painful lump on my left clavicle closest to my neck. · Healthcare visit (other): Since I just noticed it, and its part of the holiday weekend, I will consult with my family doctor tomorrow and see how to proceed.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-05
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-08
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2021-10-04
Survey response — 6 months, dose 2MedDRA: Endodontic procedure, Headache, Office visit, Pain, Swelling, Tooth abscess — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Dental abscess under molar withcrown: pain & headache -collar bone enlarged on left side · Healthcare visit (other): dental appointment for diagnosis as well as root canal by a root canal specialistMedDRA releases: 2024-11 · check-in free text available
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2021-10-04
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-10-05
- 2021-10-06
- 2021-10-07
- 2021-10-08
- 2021-10-08
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2021-10-08
Call successfulCompleted over the phone
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2022-04-05
Survey response — 12 months, dose 2MedDRA: Energy increased, Nasopharyngitis, Pre-existing disease, Rhinorrhoea, SARS-CoV-2 test negative, Sneezing — Feeling: FairFree text: Either a mild cold or allergiesSneezing, runny nose, no fever.still have lots of energy.took at home Covid test yesterday, just in case it was negative.. Will take another test. I just didn't like the runny nose (or the sneezing).MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-08 | Moderna | |
| 2 | 2021-04-05 | Moderna |
Call center
2 call center cases
2 successful
VAERS report filed, before or during a call: 2
Free text
Release 6 — day 14, dose 1
Symptoms: Arm rash in shot area is bigger; arm seems a bit swollen, and a bit achy and strange at times. Some body aches in different areas (did not have them before shot). Looser bowels than normal. Tiredness.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Temp suddenly spiked to almost 104 yesterday, so Ive been taking Tylenol since then.
Systemic reaction (other): The temperature I reported is with Tylenol in my system. My energy levels are low.
Systemic reaction (other): My normal body temp is in the 97 degree range. For me to have a 99.34 temp with Tylenol in my system means I m running a low grade fever.
Systemic reaction (other): Note: I am running roughly 2 degrees above my normal body temperature which is in the 97 range. I tire very easily. With the swelling in my arm, an indentation like a dimple from cellulite has formed.
Systemic reaction (other): A dimple (reminiscent of cellulite) appeared in the swollen patch of rash on my arm.
Release 7 — day 7, dose 2
Systemic reaction (other): A question..Is it ok that my temp gets into the 99 range when my normal body temp is in the 97 range?
Release 9 — 3 months, dose 2
Symptoms: I just noticed a hard, enlarged, non-painful lump on my left clavicle closest to my neck.
Healthcare visit (other): Since I just noticed it, and its part of the holiday weekend, I will consult with my family doctor tomorrow and see how to proceed.
Release 9 — 6 months, dose 2
Symptoms: Dental abscess under molar withcrown: pain & headache -collar bone enlarged on left side
Healthcare visit (other): dental appointment for diagnosis as well as root canal by a root canal specialist
Release 11 — 12 months, dose 2
Symptoms: Either a mild cold or allergiesSneezing, runny nose, no fever.still have lots of energy.took at home Covid test yesterday, just in case it was negative.. Will take another test. I just didn't like the runny nose (or the sneezing).
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 | Endodontic procedure | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| HCVO | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Energy increased | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Feeling abnormal | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Induration | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Peripheral swelling | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SD | Swelling | · | · | ✓ |
| SD | Tooth abscess | · | · | ✓ |
| SRO | Asthenia | ✓ | ✓ | ✓ |
| SRO | Body temperature increased | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Peripheral swelling | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release