5GJ-12684-18606
2 vaccinations
5 coded responses
25 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 152 / PA
- Registered
- 2021-03-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-17
Registered in v-safe
-
2021-03-17
Dose 1 — Moderna
- 2021-03-17
- 2021-03-18
-
2021-03-19
Survey response — days 1–6 daily, dose 1MedDRA: Musculoskeletal stiffness, Pain, Pre-existing disease — Feeling: Good · Site: PainFree text: Pain/stiffness lessened throughout the day. Also, want to let you know for records that I have autoimmune disease - Hashimotos Disease in thyroid should you be tracking responses in people like me.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-24
-
2021-03-31
Survey response — day 14, dose 1MedDRA: Headache — Feeling: GoodFree text: I have been getting these strange passing headaches. Its like there is a very brief mild pain that passes across the temple to the top of the head and then its over (no more than 10-15 seconds). This occurs 1-2xs a day since shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-07
-
2021-04-14
Dose 2 — Moderna
-
2021-04-14
Survey response — day 0, dose 2MedDRA: Tinnitus — Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activitiesFree text: For about an or two after the shot, I had tinnitusMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-15
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-16
- 2021-04-17
- 2021-04-18
- 2021-04-19
- 2021-04-21
-
2021-04-28
Survey response — day 14, dose 2MedDRA: Arthralgia — Feeling: FairFree text: Joint painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-05
- 2021-05-12
- 2021-05-19
- 2021-05-26
- 2021-07-14
- 2021-10-13
-
2022-04-16
Survey response — 12 months, dose 2MedDRA: Menstrual disorder, Vaginal haemorrhage — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Having gynocological issues. Abnormal bleeding.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-16
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-04-21
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-17 | Moderna | |
| 2 | 2021-04-14 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Pain/stiffness lessened throughout the day. Also, want to let you know for records that I have autoimmune disease - Hashimotos Disease in thyroid should you be tracking responses in people like me.
Release 6 — day 14, dose 1
Symptoms: I have been getting these strange passing headaches. Its like there is a very brief mild pain that passes across the temple to the top of the head and then its over (no more than 10-15 seconds). This occurs 1-2xs a day since shot.
Release 7 — day 0, dose 2
Systemic reaction (other): For about an or two after the shot, I had tinnitus
Release 8 — day 14, dose 2
Symptoms: Joint pain
Release 11 — 12 months, dose 2
Symptoms: Having gynocological issues. Abnormal bleeding.
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 | Arthralgia | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Menstrual disorder | · | · | ✓ |
| SD | Vaginal haemorrhage | · | · | ✓ |
| SRO | Musculoskeletal stiffness | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Tinnitus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release