5JJ-14493-81186
3 vaccinations
5 coded responses
34 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 936 / CA
- Registered
- 2021-03-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-04
Registered in v-safe
-
2021-03-04
Dose 1 — Moderna
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
-
2021-03-18
Survey response — day 14, dose 1MedDRA: Injection site erythema, Injection site pruritus, Rash macular — Feeling: GoodFree text: At day 8 or 9 my red spot reappeared, was about 1.5x1.5 and below the injection site. It was itchy for 24 hours and then disappeared at 72 hours.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-25
- 2021-04-01
-
2021-04-08
Dose 2 — Moderna
- 2021-04-15
- 2021-04-22
- 2021-04-29
- 2021-05-06
- 2021-05-13
- 2021-05-20
- 2021-07-08
- 2021-10-07
-
2021-11-10
Dose 3 — Moderna
-
2021-11-11
Survey response — days 1–6 daily, dose 3MedDRA: Musculoskeletal stiffness — Feeling: Fair · Site: Pain · Muscle or body achesFree text: Stuff neckMedDRA releases: 2024-11 · check-in free text available
- 2021-11-12
- 2021-11-13
- 2021-11-14
- 2021-11-15
- 2021-11-16
- 2021-11-17
-
2021-11-24
Survey response — day 14, dose 3MedDRA: Headache, Musculoskeletal stiffness — Feeling: FairFree text: Low grade headache located in lower region of back of skull. Stiff neck and shoulders. I've had it a week and thought it was due to new glasses with tight earpieces. After having them "loosened" did not relieve the headache.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-01
- 2021-12-08
- 2021-12-15
- 2021-12-22
- 2022-02-09
-
2022-05-11
Survey response — 6 months, dose 3MedDRA: Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Sinus infectionMedDRA releases: 2024-11 · check-in free text available
-
2022-05-11
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-05-12
-
2022-11-10
Survey response — 12 months, dose 3MedDRA: Osteoarthritis — 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: Osteoarthritis of hip requiring hip replacementMedDRA releases: 2024-11 · check-in free text available
-
2022-11-10
Report sent to call center — 12 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)
- 2022-11-11
- 2022-11-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-04 | Moderna | |
| 2 | 2021-04-08 | Moderna | |
| 3 | 2021-11-10 | Moderna | No |
Call center
2 call center cases
2 unsuccessful
Free text
Release 5 — day 14, dose 1
Symptoms: At day 8 or 9 my red spot reappeared, was about 1.5x1.5 and below the injection site. It was itchy for 24 hours and then disappeared at 72 hours.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Stuff neck
Release 10 — day 14, dose 3
Symptoms: Low grade headache located in lower region of back of skull. Stiff neck and shoulders. I've had it a week and thought it was due to new glasses with tight earpieces. After having them "loosened" did not relieve the headache.
Release 11 — 6 months, dose 3
Symptoms: Sinus infection
Release 12 — 12 months, dose 3
Symptoms: Osteoarthritis of hip requiring hip replacement
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 | Headache | · | · | ✓ |
| SD | Injection site erythema | ✓ | · | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Musculoskeletal stiffness | · | · | ✓ |
| SD | Osteoarthritis | · | · | ✓ |
| SD | Rash macular | ○ | ✓ | ○ |
| SD | Sinusitis | · | · | ✓ |
| SRO | Musculoskeletal stiffness | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release