5GE-18743-75290
5 vaccinations
6 coded responses
32 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 481 / MI
- Registered
- 2021-02-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-20
Dose 1 — Moderna
-
2021-02-13
Registered in v-safe
-
2021-02-13
Survey response — day 21, dose 1MedDRA: Blister, Injection site pruritus, Injection site urticaria, Pain in extremity — Feeling: GoodFree text: Sore arm on the 01/20 - gone w/in 24hrs. But on, 01/25/21, experienced 3 small itchy hives within a few inches of injection point, lasting ~ 2hrs. On 01/26/21, 1.5mm itchy blister on right foot appeared, lasting ~ 2hrs. No other unusual symptoms.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-17
Dose 2 — Moderna
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-20
-
2021-02-21
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia — Feeling: Good · Joint painsFree text: woke up with unexplained joint pain with 2 toes to left of big toe on left foot - lasted ~ 2hrsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-22
Survey response — days 1–6 daily, dose 2MedDRA: Muscle spasms — Feeling: Good · Muscle or body achesFree text: Right leg calf muscle feels/acts like it wants to "cramp" or "seize/lock upMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-23
- 2021-02-24
- 2021-03-03
- 2021-03-10
-
2021-03-17
Survey response — day 28, dose 2MedDRA: Injection site erythema, Injection site swelling — Feeling: GoodFree text: Near injection site - 2 mm red bump appeared 16-Mar persisting on 17-Mar - not itchy, not soreMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
- 2021-03-31
- 2021-05-19
- 2021-08-18
-
2021-11-12
Dose 3 — Moderna
- 2022-02-17
-
2022-03-31
Dose 4 — Moderna
-
2022-10-10
Dose 5 — Moderna
- 2022-10-10
-
2022-10-11
Survey response — days 1–6 daily, dose 5MedDRA: Pain, Pain in extremity — Feeling: Good · Site: Itching · Muscle or body achesFree text: RE: body ache -abt. 12 hrs after shot (left arm), abruptly started experienced "throb" type pain midway between where the left leg joins the torso and the vulva region. Still present as of this report.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-12
- 2022-10-13
- 2022-10-14
- 2022-10-15
- 2022-10-16
- 2022-10-17
- 2022-10-24
- 2022-10-31
- 2022-11-07
- 2022-11-14
- 2022-11-21
- 2023-01-10
-
2023-04-10
Survey response — 6 months, dose 5MedDRA: Dyshidrotic eczema, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
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2023-04-10
Report sent to call center — 6 months, dose 5Get care from a doctor or other healthcare professional1 call case(s)
- 2023-04-11
-
2023-04-12
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-20 | Moderna | |
| 2 | 2021-02-17 | Moderna | |
| 3 | 2021-11-12 | Moderna | No |
| 4 | 2022-03-31 | Moderna | No |
| 5 | 2022-10-10 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 4 — day 21, dose 1
Symptoms: Sore arm on the 01/20 - gone w/in 24hrs. But on, 01/25/21, experienced 3 small itchy hives within a few inches of injection point, lasting ~ 2hrs. On 01/26/21, 1.5mm itchy blister on right foot appeared, lasting ~ 2hrs. No other unusual symptoms. cut off by CDC
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): woke up with unexplained joint pain with 2 toes to left of big toe on left foot - lasted ~ 2hrs
Systemic reaction (other): Right leg calf muscle feels/acts like it wants to "cramp" or "seize/lock up
Release 5 — day 28, dose 2
Symptoms: Near injection site - 2 mm red bump appeared 16-Mar persisting on 17-Mar - not itchy, not sore
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): RE: body ache -abt. 12 hrs after shot (left arm), abruptly started experienced "throb" type pain midway between where the left leg joins the torso and the vulva region. Still present as of this report.
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 | Office visit | · | · | ✓ |
| SD | Blister | ✓ | ✓ | ✓ |
| SD | Dyshidrotic eczema | · | · | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site swelling | ✓ | ✓ | ✓ |
| SD | Injection site urticaria | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Muscle spasms | ✓ | ✓ | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release