5JB-30996-47069
5 vaccinations
15 coded responses
69 check-ins
13 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 125 / NY
- Registered
- 2021-03-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-11
Registered in v-safe
-
2021-03-11
Dose 1 — Moderna
- 2021-03-11
- 2021-03-12
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
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2021-03-25
Survey response — day 14, dose 1MedDRA: Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth — Feeling: GoodFree text: Redness, hard, swollen hot to touch. Injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-01
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2021-04-06
Dose 2 — Moderna
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2021-04-06
Survey response — day 0, dose 2MedDRA: Injection site pain, Nodule — Feeling: Good · Site: SwellingFree text: Arm feels hard and a little tender at site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-08
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
- 2021-04-09
- 2021-04-10
- 2021-04-11
- 2021-04-12
- 2021-04-13
- 2021-04-20
- 2021-04-27
- 2021-05-04
- 2021-05-11
- 2021-05-18
- 2021-07-06
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2021-10-05
Survey response — 6 months, dose 2MedDRA: Arthralgia, Lymphadenopathy — Feeling: Good · Be unable to do your normal daily activitiesFree text: I had a reactions to my Dpt vaccine which previously never occurred. Swollen glands under arms and sore joints.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-18
Dose 3 — Moderna
- 2021-11-18
-
2021-11-19
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Swelling · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-11-20
Survey response — days 1–6 daily, dose 3MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling · Fatigue or tirednessFree text: Glands under injection arm are swollenMedDRA releases: 2024-11 · check-in free text available
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2021-11-21
Survey response — days 1–6 daily, dose 3MedDRA: Lymphadenopathy — Feeling: Good · Site: SwellingFree text: Glands under arm still swollen but less than yesterdayMedDRA releases: 2024-11 · check-in free text available
-
2021-11-22
Survey response — days 1–6 daily, dose 3MedDRA: Oedema peripheral — Feeling: Good · Site: SwellingFree text: Swelling under the arm is almost goneMedDRA releases: 2024-11 · check-in free text available
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2021-11-23
Survey response — days 1–6 daily, dose 3MedDRA: Swelling, Tenderness — Feeling: Good · Site: Pain, SwellingFree text: Very mimor pain to touch and swelling almost completely goneMedDRA releases: 2024-11 · check-in free text available
- 2021-11-24
- 2021-11-25
- 2021-12-02
- 2021-12-09
- 2021-12-16
- 2021-12-23
- 2021-12-30
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2022-02-17
Survey response — 3 months, dose 3MedDRA: Lymph node pain, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Tenderness to glands under arm · Healthcare visit (other): Had sonogram of breast tissue after mammogramMedDRA releases: 2024-11 · check-in free text available
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2022-02-17
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
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2022-02-21
Call successfulCompleted over the phone
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2022-04-01
Dose 4 — Moderna
- 2022-04-01
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2022-04-02
Survey response — days 1–6 daily, dose 4MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Swollen glands under armMedDRA releases: 2024-11 · check-in free text available
-
2022-04-03
Survey response — days 1–6 daily, dose 4MedDRA: Chills, Feeling hot, Injection site warmth — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tirednessFree text: Overheating & chills, arm is warm at injection site, symptoms were worse last nightMedDRA releases: 2024-11 · check-in free text available
- 2022-04-04
-
2022-04-05
Survey response — days 1–6 daily, dose 4MedDRA: Injection site swelling — Feeling: Good · Site: ItchingFree text: Still minor swelling at injection site, no pain.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-06
- 2022-04-07
- 2022-04-08
- 2022-04-15
- 2022-04-23
- 2022-04-29
- 2022-05-06
- 2022-05-13
- 2022-07-01
- 2022-09-30
-
2022-11-03
Dose 5 — Moderna
- 2022-11-03
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2022-11-04
Health check-in — days 1–6 daily, dose 5Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
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2022-11-05
Survey response — days 1–6 daily, dose 5MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain, Redness, SwellingFree text: Swollen glands under my armMedDRA releases: 2024-11 · check-in free text available
- 2022-11-06
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2022-11-07
Survey response — days 1–6 daily, dose 5MedDRA: Feeling hot — Feeling: Fair · Fever · Headache, DiarrheaFree text: Feel like im overheatingMedDRA releases: 2024-11 · check-in free text available
- 2022-11-08
- 2022-11-09
- 2022-11-10
- 2022-11-17
- 2022-11-24
- 2022-12-01
- 2022-12-08
- 2022-12-15
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2023-02-02
Survey response — 3 months, dose 5MedDRA: Upper respiratory tract infection — Feeling: Fair · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
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2023-05-04
Survey response — 6 months, dose 5MedDRA: Abdominal pain upper, Feeling abnormal, Headache, Lacrimation increased, Oropharyngeal pain, Pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-11 | Moderna | |
| 2 | 2021-04-06 | Moderna | |
| 3 | 2021-11-18 | Moderna | No |
| 4 | 2022-04-01 | Moderna | No |
| 5 | 2022-11-03 | Moderna | No |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 6 — day 14, dose 1
Symptoms: Redness, hard, swollen hot to touch. Injection site.
Release 7 — day 0, dose 2
Systemic reaction (other): Arm feels hard and a little tender at site.
Release 10 — 6 months, dose 2
Symptoms: I had a reactions to my Dpt vaccine which previously never occurred. Swollen glands under arms and sore joints.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Glands under injection arm are swollen
Systemic reaction (other): Glands under arm still swollen but less than yesterday
Systemic reaction (other): Swelling under the arm is almost gone
Systemic reaction (other): Very mimor pain to touch and swelling almost completely gone
Release 11 — 3 months, dose 3
Symptoms: Tenderness to glands under arm
Healthcare visit (other): Had sonogram of breast tissue after mammogram
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Swollen glands under arm
Systemic reaction (other): Overheating & chills, arm is warm at injection site, symptoms were worse last night
Systemic reaction (other): Still minor swelling at injection site, no pain.
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Swollen glands under my arm
Systemic reaction (other): Feel like im overheating
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 | Unevaluable event | · | · | ✓ |
| SD | Abdominal pain upper | · | · | ✓ |
| SD | Arthralgia | · | · | ✓ |
| SD | Feeling abnormal | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site induration | ✓ | ✓ | ✓ |
| SD | Injection site swelling | ✓ | · | ✓ |
| SD | Injection site warmth | ✓ | ✓ | ✓ |
| SD | Lacrimation increased | · | · | ✓ |
| SD | Lymph node pain | · | · | ✓ |
| SD | Lymphadenopathy | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Feeling hot | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site swelling | · | · | ✓ |
| SRO | Injection site warmth | · | · | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Nodule | ✓ | ✓ | ✓ |
| SRO | Oedema peripheral | · | · | ✓ |
| SRO | Swelling | · | · | ✓ |
| SRO | Tenderness | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release