5JF-30653-77496
5 vaccinations
4 coded responses
51 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 024 / MA
- Registered
- 2021-01-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-23
Registered in v-safe
-
2021-01-23
Dose 1 — Moderna
- 2021-01-23
- 2021-01-24
-
2021-01-25
Survey response — days 1–6 daily, dose 1MedDRA: Oral herpes — Feeling: Good · Site: PainFree text: A cold sore on my lip started yesterday. I dont usually get them. Minor and probably not related to the vaccine but thought Id let you knowMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-26
Survey response — days 1–6 daily, dose 1MedDRA: Oral herpes — Feeling: GoodFree text: I have a cold sore on my lip that started the day after the vaccine. Its minor and probably unrelated but thought I would let you knowMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-27
- 2021-01-28
-
2021-01-29
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Muscle or body aches, Abdominal painAdult check-in
- 2021-01-30
- 2021-02-06
- 2021-02-13
-
2021-02-20
Dose 2 — Moderna
- 2021-02-20
-
2021-02-21
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-22
- 2021-02-23
-
2021-02-24
Survey response — days 1–6 daily, dose 2MedDRA: Oral herpes, Vaccine positive rechallenge — Feeling: GoodFree text: Cold sore on my lip. This also happened after my first dose. It healed and now another has appeared after my second doseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-25
- 2021-02-26
- 2021-02-27
- 2021-03-06
- 2021-03-13
- 2021-03-20
- 2021-03-27
- 2021-04-03
- 2021-05-22
- 2021-08-21
-
2021-09-09
Dose 3 — Moderna
- 2021-12-09
-
2022-03-10
Survey response — 6 months, dose 3MedDRA: Wrist fracture — 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 visitFree text: Wrist fractureMedDRA releases: 2024-11 · check-in free text available
-
2022-03-10
Report sent to call center — 6 months, dose 3Be 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)
- 2022-03-11
-
2022-03-11
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-03-30
Dose 4 — Moderna
- 2022-03-30
- 2022-04-01
- 2022-04-02
- 2022-04-03
- 2022-04-04
- 2022-04-05
- 2022-04-06
- 2022-04-13
- 2022-04-20
- 2022-04-27
- 2022-05-04
- 2022-05-11
- 2022-06-29
-
2022-09-09
Dose 5 — ModernaCo-administered: Flu
-
2022-09-10
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2022-09-11
- 2022-09-12
- 2022-09-16
- 2022-09-23
- 2022-09-30
- 2022-10-07
- 2022-10-14
- 2022-10-21
- 2022-12-09
- 2023-03-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-23 | Moderna | |
| 2 | 2021-02-20 | Moderna | |
| 3 | 2021-09-09 | Moderna | No |
| 4 | 2022-03-30 | Moderna | No |
| 5 | 2022-09-09 | Moderna | Flu |
Call center
1 call center case
1 successful
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): A cold sore on my lip started yesterday. I dont usually get them. Minor and probably not related to the vaccine but thought Id let you know
Systemic reaction (other): I have a cold sore on my lip that started the day after the vaccine. Its minor and probably unrelated but thought I would let you know
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Cold sore on my lip. This also happened after my first dose. It healed and now another has appeared after my second dose
Release 11 — 6 months, dose 3
Symptoms: Wrist fracture
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 | Wrist fracture | · | · | ✓ |
| SRO | Oral herpes | ✓ | ✓ | ✓ |
| SRO | Vaccine positive rechallenge | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release