5J6-27699-56834
5 vaccinations
11 coded responses
53 check-ins
10 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 158 / PA
- Registered
- 2021-02-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-02
Registered in v-safe
-
2021-02-02
Dose 1 — Moderna
- 2021-02-02
-
2021-02-03
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · None · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-04
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: GoodFree text: My arm around the site is sore but better today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-06
Survey response — days 1–6 daily, dose 1MedDRA: Diarrhoea, Fatigue — Feeling: GoodFree text: Fatigue and Diarrhea YesterdayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-16
- 2021-02-23
-
2021-03-02
Dose 2 — Moderna
-
2021-03-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-16
-
2021-03-23
Survey response — day 21, dose 2MedDRA: Pain, Pain in extremity — Feeling: GoodFree text: Actually my left arm has been sore, it remains sore. It is noticeable as I raise my arm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-30
- 2021-04-06
- 2021-04-13
- 2021-06-01
- 2021-08-31
-
2021-10-22
Dose 3 — Moderna
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-11-05
-
2021-11-12
Survey response — day 21, dose 3MedDRA: Eye irritation, Malaise, Respiratory disorder — Feeling: FairFree text: I may have a sinus infection , some breathing issues. I took an antihistamine and used a Albuterol Sulfate HFA inhaler. I do not feel well but I am able to complete my daily tasks. My eyes are burning, may be due to allergies.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-19
-
2021-11-26
Survey response — day 35, dose 3MedDRA: Office visit, Swelling face, Unevaluable event — Feeling: FairFree text: Some swelling in the right temple. My physician has been aware, I had one small indicator showing a rise for a possible autoimmune disease. Dr checked many areas and nothing showed up. I will see a Rheumatologist on March 15th. I was put on PrednisonMedDRA releases: 2024-11 · check-in free text available
- 2021-12-03
- 2022-01-21
- 2022-04-22
-
2022-05-19
Dose 4 — Moderna
- 2022-05-19
-
2022-05-20
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2022-05-21
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
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2022-05-22
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2022-05-23
Survey response — days 1–6 daily, dose 4MedDRA: Poor quality sleep — Feeling: Fair · Fatigue or tirednessFree text: Not sleeping wellMedDRA releases: 2024-11 · check-in free text available
- 2022-05-24
- 2022-05-25
- 2022-05-26
-
2022-06-02
Survey response — day 14, dose 4MedDRA: Vaccination site pain — Feeling: FairFree text: A persistent left sore arm where I received the vaccine, it started a week ago.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-09
- 2022-06-16
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2022-06-23
Survey response — day 35, dose 4MedDRA: Fluid retention — Feeling: FairFree text: I appear to be retaining fluid. I do not use salt and I am trying to drink more. My legs and knees show the fluid retention. I will see my physician in July.MedDRA releases: 2024-11 · check-in free text available
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2022-06-30
Survey response — day 42, dose 4MedDRA: Asthenia, Blood pressure decreased, Fall, Malaise, Rehabilitation therapy — Feeling: Fair · Be unable to do your normal daily activitiesFree text: I am getting therapy for a fall I had in February. I didn't feel well afterwards. I stopped to get a gift. I felt weak I left. I picked up lunch I came home and took my BP, it was low, this is not normal for me. maybe it is the cuff, I'll check it.MedDRA releases: 2024-11 · check-in free text available
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2022-08-18
Survey response — 3 months, dose 4MedDRA: Erythema, Fatigue, Muscle mass, Pain in extremity, Peripheral swelling — Feeling: Fair · Be unable to do your normal daily activitiesFree text: My left arm has been sore and there is a lump in the upper arm muscle dice my shot. My big toes have been swollen red and painful. My physician put me on an anti inflammatory medication. I have felt fatigued, definitely not with my regular energy.MedDRA releases: 2024-11 · check-in free text available
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2022-10-06
Dose 5 — Pfizer-BioNTech
- 2022-10-20
- 2022-10-27
- 2022-11-03
- 2022-11-10
- 2022-11-19
- 2023-01-05
-
2023-04-06
Survey response — 6 months, dose 5MedDRA: Fatigue, Limb injury, Office visit, Physiotherapy, Poor quality sleep, Tooth disorder — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
-
2023-04-06
Report sent to call center — 6 months, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2023-04-07
Call successfulNot applicable - Accidental Reporting
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-02 | Moderna | |
| 2 | 2021-03-02 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
| 4 | 2022-05-19 | Moderna | No |
| 5 | 2022-10-06 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): My arm around the site is sore but better today.
Systemic reaction (other): Fatigue and Diarrhea Yesterday
Release 6 — day 21, dose 2
Symptoms: Actually my left arm has been sore, it remains sore. It is noticeable as I raise my arm.
Release 10 — day 21, dose 3
Symptoms: I may have a sinus infection , some breathing issues. I took an antihistamine and used a Albuterol Sulfate HFA inhaler. I do not feel well but I am able to complete my daily tasks. My eyes are burning, may be due to allergies.
Release 10 — day 35, dose 3
Symptoms: Some swelling in the right temple. My physician has been aware, I had one small indicator showing a rise for a possible autoimmune disease. Dr checked many areas and nothing showed up. I will see a Rheumatologist on March 15th. I was put on Prednison cut off by CDC
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Not sleeping well
Release 11 — day 14, dose 4
Symptoms: A persistent left sore arm where I received the vaccine, it started a week ago.
Release 12 — day 35, dose 4
Symptoms: I appear to be retaining fluid. I do not use salt and I am trying to drink more. My legs and knees show the fluid retention. I will see my physician in July.
Release 12 — day 42, dose 4
Symptoms: I am getting therapy for a fall I had in February. I didn't feel well afterwards. I stopped to get a gift. I felt weak I left. I picked up lunch I came home and took my BP, it was low, this is not normal for me. maybe it is the cuff, I'll check it. cut off by CDC
Release 12 — 3 months, dose 4
Symptoms: My left arm has been sore and there is a lump in the upper arm muscle dice my shot. My big toes have been swollen red and painful. My physician put me on an anti inflammatory medication. I have felt fatigued, definitely not with my regular energy.
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 | · | · | ✓ |
| HCVO | Physiotherapy | · | · | ✓ |
| SD | Asthenia | · | · | ✓ |
| SD | Blood pressure decreased | · | · | ✓ |
| SD | Erythema | · | · | ✓ |
| SD | Eye irritation | · | · | ✓ |
| SD | Fall | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Fluid retention | · | · | ✓ |
| SD | Limb injury | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Muscle mass | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Peripheral swelling | · | · | ✓ |
| SD | Physiotherapy | · | · | ✓ |
| SD | Poor quality sleep | · | · | ✓ |
| SD | Rehabilitation therapy | · | · | ✓ |
| SD | Respiratory disorder | · | · | ✓ |
| SD | Swelling face | · | · | ✓ |
| SD | Tooth disorder | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SD | Vaccination site pain | · | · | ✓ |
| SRO | Diarrhoea | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Poor quality sleep | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release