5GR-15233-82789
5 vaccinations
9 coded responses
67 check-ins
8 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 907 / CA
- Registered
- 2021-01-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-22
Registered in v-safe
-
2021-01-22
Dose 1 — Moderna
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-02-05
- 2021-02-12
- 2021-02-19
-
2021-02-23
Dose 2 — Moderna
- 2021-02-23
-
2021-02-24
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-25
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-02-26
Survey response — days 1–6 daily, dose 2MedDRA: Injection site erythema, Injection site warmth — Feeling: Good · Site: Pain, Redness, Swelling, ItchingFree text: THE INJECTION SITE IS ALSO HOT WHERE IT IS RED..MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-27
-
2021-02-28
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Joint pains, Fatigue or tirednessAdult check-in
- 2021-03-01
- 2021-03-02
-
2021-03-09
Survey response — day 14, dose 2MedDRA: Arthralgia, Diarrhoea, Fatigue — Feeling: GoodFree text: Diarrhea, continued joint pain especially in my left shoulder (injection arm) and both knees, and fatigue.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-16
Survey response — day 21, dose 2MedDRA: Acupuncture, Arthralgia — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Continuing pain in my joints, especially my left shoulder, right elbow and my knees. I have been seeing an acupuncturist. · Healthcare visit (other): AcupunctureMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-16
Report sent to call center — day 21, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-03-24
Survey response — day 28, dose 2MedDRA: Arthralgia, Pre-existing disease, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: My left shoulder continued, very painful. I was concerned about SIRVA. I had a shoulder x-ray that showed osteophytosis in the acromioclavicular joint & mild degenerative changes. No soft tissue changes seen. RX 5 mg preidsone pain is gone in 2 days · Healthcare visit (other): X-rayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-24
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-30
Survey response — day 35, dose 2MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Left shoulder pain diagnosed as related to pinched nerve in neck. Ortho consult tomorrow for bone spurs and slight degeneration in the left shoulder.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-30
Report sent to call center — day 35, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-06
- 2021-05-25
- 2021-08-25
-
2021-10-26
Dose 3 — Moderna
- 2021-10-26
-
2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-04
- 2021-11-09
- 2021-11-16
- 2021-11-23
- 2021-11-30
- 2021-12-07
- 2021-12-30
- 2022-01-05
- 2022-01-25
-
2022-04-13
Dose 4 — Moderna
-
2022-04-14
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2022-04-15
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Swelling · Muscle or body achesAdult check-in
-
2022-04-16
Survey response — days 1–6 daily, dose 4MedDRA: Injection site erythema — Feeling: Good · Site: Pain, RednessFree text: I noticed the large red circle at the injection site yesterday after I had submitted my report.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-17
- 2022-04-18
- 2022-04-19
- 2022-04-20
- 2022-04-28
- 2022-05-05
- 2022-05-11
- 2022-05-18
- 2022-05-25
- 2022-07-13
-
2022-10-06
Dose 5 — Moderna
-
2022-10-07
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-10-08
- 2022-10-09
- 2022-10-10
-
2022-10-11
Survey response — days 1–6 daily, dose 5MedDRA: Fatigue, Injection site pain — Feeling: GoodFree text: I received a flu shot yesterday. I felt tired this morning and my right arm is very sore where I got the flu shot.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-12
-
2022-10-13
Survey response — day 7, dose 5MedDRA: Dyspnoea, Heart rate increased, Hypertension — Feeling: Poor · Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Shortness of breath, rapid heart beat, very high blood pressureMedDRA releases: 2024-11 · check-in free text available
-
2022-10-13
Report sent to call center — day 7, dose 5Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2022-10-14
- 2022-10-14
- 2022-10-14
- 2022-10-14
- 2022-10-17
- 2022-10-20
-
2022-10-25
Callback requested for01:00PM ET
-
2022-10-25
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-10-25
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-10-25
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-10-25
Call successfulCompleted over the phone
- 2022-10-27
- 2022-11-03
- 2022-11-10
- 2022-11-19
- 2023-01-05
-
2023-04-10
Survey response — 6 months, dose 5MedDRA: Basal cell carcinoma, Physiotherapy, Tendon rupture — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-04-10
Report sent to call center — 6 months, dose 5Be 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)
-
2023-04-12
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-22 | Moderna | |
| 2 | 2021-02-23 | Moderna | |
| 3 | 2021-10-26 | Moderna | No |
| 4 | 2022-04-13 | Moderna | No |
| 5 | 2022-10-06 | Moderna | No |
Call center
5 call center cases
5 successful
VAERS report filed, before or during a call: 1
3 waits over 3 months for a first call
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): THE INJECTION SITE IS ALSO HOT WHERE IT IS RED..
Release 5 — day 14, dose 2
Symptoms: Diarrhea, continued joint pain especially in my left shoulder (injection arm) and both knees, and fatigue.
Release 5 — day 21, dose 2
Symptoms: Continuing pain in my joints, especially my left shoulder, right elbow and my knees. I have been seeing an acupuncturist.
Healthcare visit (other): Acupuncture
Release 6 — day 28, dose 2
Symptoms: My left shoulder continued, very painful. I was concerned about SIRVA. I had a shoulder x-ray that showed osteophytosis in the acromioclavicular joint & mild degenerative changes. No soft tissue changes seen. RX 5 mg preidsone pain is gone in 2 days cut off by CDC
Healthcare visit (other): X-ray
Release 6 — day 35, dose 2
Symptoms: Left shoulder pain diagnosed as related to pinched nerve in neck. Ortho consult tomorrow for bone spurs and slight degeneration in the left shoulder.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): I noticed the large red circle at the injection site yesterday after I had submitted my report.
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): I received a flu shot yesterday. I felt tired this morning and my right arm is very sore where I got the flu shot.
Release 12 — day 7, dose 5
Systemic reaction (other): Shortness of breath, rapid heart beat, very high blood pressure
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 | Acupuncture | ✓ | ✓ | ✓ |
| HCVO | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Basal cell carcinoma | · | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Physiotherapy | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Tendon rupture | · | · | ✓ |
| SRO | Dyspnoea | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Heart rate increased | · | · | ✓ |
| SRO | Hypertension | · | · | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Injection site warmth | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release