5KF-29872-40845
5 vaccinations
6 coded responses
69 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 910 / CA
- Registered
- 2021-01-28
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-28
Registered in v-safe
-
2021-01-28
Dose 1 — Moderna
-
2021-01-28
Survey response — day 0, dose 1MedDRA: Fatigue — Feeling: GoodFree text: fatigue in left arm (injection arm) starting about 4.5 hours after injectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-29
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-11
- 2021-02-18
- 2021-02-25
-
2021-03-04
Dose 2 — Moderna
- 2021-03-04
-
2021-03-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Itching · Headache, Muscle or body achesAdult check-in
-
2021-03-07
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-04-01
-
2021-04-08
Survey response — day 35, dose 2MedDRA: Gingival swelling — Feeling: GoodFree text: Have had swollen gums on & off since day 3 after vaccination #2. Its not an infection as its been checked by periodontist. Seems to settle down with Tylenol but returns on & off.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-15
- 2021-06-03
- 2021-09-03
-
2021-10-25
Dose 3 — Moderna
-
2021-10-25
Health check-in — day 0, dose 3Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-10-26
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-10-30
-
2021-10-31
Health check-in — days 1–6 daily, dose 3Feeling: Good · Headache, Fatigue or tirednessAdult check-in
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2022-01-24
- 2022-04-25
-
2022-04-30
Dose 4 — Moderna
- 2022-04-30
-
2022-05-02
Survey response — days 1–6 daily, dose 4MedDRA: Peripheral coldness — Feeling: Good · Site: Pain · Chills, Muscle or body aches, Fatigue or tirednessFree text: cold extremities yesterday but not todayMedDRA releases: 2024-11 · check-in free text available
- 2022-05-03
- 2022-05-04
- 2022-05-05
- 2022-05-06
- 2022-05-07
- 2022-05-14
- 2022-05-22
- 2022-05-28
- 2022-06-04
- 2022-06-11
- 2022-07-30
-
2022-10-19
Dose 5 — Moderna
- 2022-10-19
-
2022-10-20
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2022-10-21
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-10-22
- 2022-10-23
-
2022-10-24
Survey response — days 1–6 daily, dose 5MedDRA: Herpes simplex, Lip blister — Feeling: GoodFree text: herpes simplex blister on my lower left lip popped up 2 days after my injection which I forgot to report; seems that this is not the 1st occurence of a blister on my lip after Covid injectionMedDRA releases: 2024-11 · check-in free text available
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2022-10-25
Survey response — days 1–6 daily, dose 5MedDRA: Oral herpes — Feeling: GoodFree text: still have herpes simplex blister on lower left lip that came up 2 days after injection & continues to be evidentMedDRA releases: 2024-11 · check-in free text available
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2022-10-26
Survey response — day 7, dose 5MedDRA: Herpes simplex, Lip blister — Feeling: GoodFree text: Still have herpes simplex blister at lower left of lip since 2 days after receiving Bivalent booster injectionMedDRA releases: 2024-11 · check-in free text available
- 2022-11-02
- 2022-11-09
- 2022-11-16
- 2022-11-23
- 2022-11-30
- 2023-01-18
- 2023-04-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-28 | Moderna | |
| 2 | 2021-03-04 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-04-30 | Moderna | No |
| 5 | 2022-10-19 | Moderna | No |
Free text
Release 3 — day 0, dose 1
Systemic reaction (other): fatigue in left arm (injection arm) starting about 4.5 hours after injection
Release 7 — day 35, dose 2
Symptoms: Have had swollen gums on & off since day 3 after vaccination #2. Its not an infection as its been checked by periodontist. Seems to settle down with Tylenol but returns on & off.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): cold extremities yesterday but not today
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): herpes simplex blister on my lower left lip popped up 2 days after my injection which I forgot to report; seems that this is not the 1st occurence of a blister on my lip after Covid injection
Systemic reaction (other): still have herpes simplex blister on lower left lip that came up 2 days after injection & continues to be evident
Release 12 — day 7, dose 5
Systemic reaction (other): Still have herpes simplex blister at lower left of lip since 2 days after receiving Bivalent booster injection
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 | Gingival swelling | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Herpes simplex | · | · | ✓ |
| SRO | Lip blister | · | · | ✓ |
| SRO | Oral herpes | · | · | ✓ |
| SRO | Peripheral coldness | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release