5JV-61910-49383
2 vaccinations
2 coded responses
18 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 970 / OR
- Registered
- 2021-03-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-01
Dose 1 — Moderna
-
2021-03-17
Registered in v-safe
- 2021-03-17
-
2021-03-22
Survey response — day 21, dose 1MedDRA: Immunisation reaction, Injection site erythema, Injection site pruritus, Injection site swelling — Feeling: GoodFree text: It seems I got Covid Arm. Large redness around the I next ion site. It showed up about 19 day after my shot 3/1/21. It itched a little. It was not raised. It did not cause any problems and is almost gone at this point-21 days post injectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-29
Dose 2 — Moderna
- 2021-03-29
-
2021-03-30
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-31
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-01
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
-
2021-04-02
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Itching · NoneAdult check-in
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-12
- 2021-04-19
- 2021-04-26
- 2021-05-03
- 2021-05-10
- 2021-06-28
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2021-09-27
Survey response — 6 months, dose 2MedDRA: Dyspnoea exertional, Fatigue, Mobility decreased, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Shortness of breath when walking a block. Mid May. Fatigue. Dr didnt think it was covid. Didnt test. Recommended more exercise which was a joke because I couldnt walk far. Heart dr ran tests. Not my heart. All disappeared around July 15. · Healthcare visit (other): In office visitMedDRA releases: 2024-11 · check-in free text available
-
2021-09-27
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)
- 2021-10-01
-
2021-10-01
Call successfulParticipant prefers to complete VAERS report online
- 2022-03-29
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-01 | Moderna | |
| 2 | 2021-03-29 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 6 — day 21, dose 1
Symptoms: It seems I got Covid Arm. Large redness around the I next ion site. It showed up about 19 day after my shot 3/1/21. It itched a little. It was not raised. It did not cause any problems and is almost gone at this point-21 days post injection
Release 9 — 6 months, dose 2
Symptoms: Shortness of breath when walking a block. Mid May. Fatigue. Dr didnt think it was covid. Didnt test. Recommended more exercise which was a joke because I couldnt walk far. Heart dr ran tests. Not my heart. All disappeared around July 15.
Healthcare visit (other): In office visit
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 | Dyspnoea exertional | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Immunisation reaction | ✓ | ✓ | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site swelling | ✓ | ✓ | ✓ |
| SD | Mobility decreased | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release