5JQ-27916-73469
3 vaccinations
11 coded responses
39 check-ins
11 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 672 / KS
- Registered
- 2021-01-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
B9G-17126-68149
Child or adolescent in my care · Female · 2021-12-21
DNN-91591-49594
Child or adolescent in my care · Female · 2021-12-21
Timeline
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2021-01-08
Registered in v-safe
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2021-01-08
Dose 1 — Moderna
- 2021-01-08
- 2021-01-09
- 2021-01-10
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2021-01-11
Survey response — days 1–6 daily, dose 1MedDRA: Respiratory tract congestion — Feeling: Fair · DiarrheaFree text: Congested.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-12
- 2021-01-13
- 2021-01-14
- 2021-01-15
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2021-01-22
Survey response — day 14, dose 1MedDRA: Unevaluable event — Feeling: FairFree text: Perhaps a lymph node in my left axillary area that is swollen and sore.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-30
Survey response — day 21, dose 1MedDRA: Migraine, Vomiting — Feeling: Poor · Be unable to do your normal daily activitiesFree text: 2 migraines, one evening of vomitingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-03
Dose 2 — Moderna
- 2021-02-03
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2021-02-04
Survey response — days 1–6 daily, dose 2MedDRA: Muscular weakness — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Weakness in extremitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-02-07
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2021-02-08
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Muscle or body achesAdult check-in
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2021-02-09
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Muscle or body achesAdult check-in
- 2021-02-10
- 2021-02-17
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2021-02-24
Survey response — day 21, dose 2MedDRA: Headache, Insomnia, Pain — Feeling: FairFree text: Difficulty sleeping, mild headaches, achiness.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-03
- 2021-03-17
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2021-05-05
Survey response — 3 months, dose 2MedDRA: Lip pain, Lip swelling, Medical counselling, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Had hyaluronic lip fillers in january before the vaccines. Had a reaction this week where my fillers/lips are very swollen and painful. Was told by PA that people with COVID Moderna vaccines have had an inflammatory reaction like a rejection.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-08-04
Survey response — 6 months, dose 2MedDRA: Bursitis, Intervertebral disc protrusion, Muscle rupture, Nerve compression, Tendonitis — Feeling: Fair · 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: Muscle tears, bulging disc, pinched nerve, bursitis, tendonitisMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-04
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-11-02
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2021-12-21
Dose 3 — Moderna
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2021-12-21
Survey response — day 0, dose 3MedDRA: No adverse event — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: I received the vaccine less than 5 hours ago.MedDRA releases: 2024-11 · check-in free text available
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2021-12-22
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
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2021-12-23
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Headache, Muscle or body aches, NauseaAdult check-in
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2021-12-24
Survey response — days 1–6 daily, dose 3MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain · Joint pains, NauseaFree text: Axillary lymph node painful and swollenMedDRA releases: 2024-11 · check-in free text available
- 2021-12-25
- 2021-12-26
- 2021-12-27
- 2021-12-28
- 2022-01-04
- 2022-01-11
- 2022-01-20
- 2022-01-25
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2022-02-03
Survey response — day 42, dose 3MedDRA: Respiratory tract congestion — Feeling: PoorFree text: Congestion.MedDRA releases: 2024-11 · check-in free text available
- 2022-03-22
- 2022-06-21
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2022-12-23
Survey response — 12 months, dose 3MedDRA: Abnormal uterine bleeding — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Abnormal uterine bleedingMedDRA releases: 2024-11 · check-in free text available
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2022-12-23
Report sent to call center — 12 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-12-27
- 2022-12-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-08 | Moderna | |
| 2 | 2021-02-03 | Moderna | |
| 3 | 2021-12-21 | Moderna | No |
Call center
2 call center cases
2 unsuccessful
1 wait over 3 months for a first call
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Congested.
Release 2 — day 14, dose 1
Symptoms: Perhaps a lymph node in my left axillary area that is swollen and sore.
Release 3 — day 21, dose 1
Symptoms: 2 migraines, one evening of vomiting
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Weakness in extremities
Release 4 — day 21, dose 2
Symptoms: Difficulty sleeping, mild headaches, achiness.
Release 8 — 3 months, dose 2
Symptoms: Had hyaluronic lip fillers in january before the vaccines. Had a reaction this week where my fillers/lips are very swollen and painful. Was told by PA that people with COVID Moderna vaccines have had an inflammatory reaction like a rejection.
Release 9 — 6 months, dose 2
Symptoms: Muscle tears, bulging disc, pinched nerve, bursitis, tendonitis
Release 10 — day 0, dose 3
Systemic reaction (other): I received the vaccine less than 5 hours ago.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Axillary lymph node painful and swollen
Release 11 — day 42, dose 3
Symptoms: Congestion.
Release 12 — 12 months, dose 3
Symptoms: Abnormal uterine bleeding
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 | Abnormal uterine bleeding | · | · | ✓ |
| SD | Bursitis | ✓ | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Insomnia | ✓ | ✓ | ✓ |
| SD | Intervertebral disc protrusion | ✓ | · | ✓ |
| SD | Lip pain | ✓ | ✓ | ✓ |
| SD | Lip swelling | ✓ | ✓ | ✓ |
| SD | Medical counselling | ✓ | ✓ | ✓ |
| SD | Migraine | ✓ | ✓ | ✓ |
| SD | Muscle rupture | ✓ | · | ✓ |
| SD | Nerve compression | ✓ | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Tendonitis | ✓ | · | ✓ |
| SD | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Vomiting | ✓ | ✓ | ✓ |
| SRO | Lymph node pain | · | · | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Muscular weakness | ✓ | ✓ | ✓ |
| SRO | No adverse event | · | · | ✓ |
| SRO | Respiratory tract congestion | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release