5JF-33377-72741
4 vaccinations
7 coded responses
31 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 068 / CT
- Registered
- 2021-02-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-12
Dose 1 — Moderna
-
2021-02-14
Registered in v-safe
- 2021-02-14
-
2021-02-16
Survey response — days 1–6 daily, dose 1MedDRA: Ocular hyperaemia — Feeling: GoodFree text: Tiny red spot in white of right eye. Had shot inright arm. No pain, burning, itching.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-17
Survey response — days 1–6 daily, dose 1MedDRA: Adverse reaction — Feeling: GoodFree text: Eye better today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-18
- 2021-02-19
- 2021-02-26
- 2021-03-05
-
2021-03-12
Dose 2 — Moderna
- 2021-03-12
-
2021-03-13
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, DiarrheaAdult check-in
-
2021-03-14
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Decreased appetite, Hyperhidrosis, Irritability, Night sweats, Pain, Secretion discharge, Sinus disorder, Sleep disorder, Sneezing — Feeling: Fair · Site: Pain, Redness · Chills, Headache, Fatigue or tirednessFree text: Bed early, no appetite. Awakened 3am sweated thru pjs tho no fever, just chills. Then one sinus tickled & stated sneezing clear mucus both sides. Still sneezing due to tickle now 5pm. Aches, chills subsiding.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-19
-
2021-03-26
Survey response — day 14, dose 2MedDRA: Diarrhoea — Feeling: GoodFree text: Diarrhea 3 days....not severeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-02
- 2021-04-10
- 2021-04-16
- 2021-04-23
- 2021-06-11
- 2021-09-12
-
2021-12-09
Dose 3 — Moderna
- 2022-03-17
-
2022-05-13
Dose 4 — Moderna
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2022-05-17
Survey response — days 1–6 daily, dose 4MedDRA: Headache, Injection site erythema, Injection site swelling — Feeling: Good · Site: Pain, Redness, Swelling · Chills, Headache, Muscle or body achesFree text: Symptoms 18 hrs after 2nd booster soon May 14th. Slight headache Sunday May 15th. Redness and slight swelling at injection site still on May 17th.MedDRA releases: 2024-11 · check-in free text available
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2022-05-22
Health check-in — day 7, dose 4Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-05-27
- 2022-06-03
- 2022-06-13
-
2022-06-17
Survey response — day 35, dose 4MedDRA: Alopecia — Feeling: GoodFree text: Have noticed losing head hair more than normal since my first booster. Have heard others say that as well. Are you finding any connection with extra non age related hair loss? If so, will it grow back w vitamins or a med? Would love to know.MedDRA releases: 2024-11 · check-in free text available
- 2022-08-13
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2022-11-13
Survey response — 6 months, dose 4MedDRA: Office visit, Periarthritis — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Frozen shoulder · Healthcare visit (other): Orthopedic for xraysMedDRA releases: 2024-11 · check-in free text available
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2022-11-13
Report sent to call center — 6 months, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2022-11-15
-
2022-11-15
Callback requested for02:30PM ET
-
2022-11-15
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-12 | Moderna | |
| 2 | 2021-03-12 | Moderna | |
| 3 | 2021-12-09 | Moderna | No |
| 4 | 2022-05-13 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Tiny red spot in white of right eye. Had shot inright arm. No pain, burning, itching.
Systemic reaction (other): Eye better today.
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Bed early, no appetite. Awakened 3am sweated thru pjs tho no fever, just chills. Then one sinus tickled & stated sneezing clear mucus both sides. Still sneezing due to tickle now 5pm. Aches, chills subsiding.
Release 6 — day 14, dose 2
Symptoms: Diarrhea 3 days....not severe
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Symptoms 18 hrs after 2nd booster soon May 14th. Slight headache Sunday May 15th. Redness and slight swelling at injection site still on May 17th.
Release 12 — day 35, dose 4
Symptoms: Have noticed losing head hair more than normal since my first booster. Have heard others say that as well. Are you finding any connection with extra non age related hair loss? If so, will it grow back w vitamins or a med? Would love to know.
Release 12 — 6 months, dose 4
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 | · | · | ✓ |
| SD | Alopecia | · | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Periarthritis | · | · | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Decreased appetite | ✓ | ✓ | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Hyperhidrosis | ✓ | ✓ | ✓ |
| SRO | Injection site erythema | · | · | ✓ |
| SRO | Injection site swelling | · | · | ✓ |
| SRO | Irritability | · | · | ✓ |
| SRO | Night sweats | · | · | ✓ |
| SRO | Ocular hyperaemia | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Secretion discharge | · | · | ✓ |
| SRO | Sinus disorder | · | · | ✓ |
| SRO | Sleep disorder | · | · | ✓ |
| SRO | Sneezing | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release