5L3-10400-12717
5 vaccinations
7 coded responses
62 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 222 / VA
- Registered
- 2021-03-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-11
Dose 1 — Moderna
-
2021-03-12
Registered in v-safe
- 2021-03-12
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-25
- 2021-04-01
-
2021-04-08
Dose 2 — Moderna
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2021-04-08
Survey response — day 0, dose 2MedDRA: No adverse event — Feeling: Good · Site: Pain, SwellingFree text: It's only been about five hours since my vaccine so the symptoms may appear later.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-09
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
-
2021-04-10
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-04-11
- 2021-04-12
- 2021-04-13
- 2021-04-14
- 2021-04-15
- 2021-04-22
- 2021-04-29
-
2021-05-06
Survey response — day 28, dose 2MedDRA: Dizziness, Fatigue, Migraine — Feeling: Good · Be unable to do your normal daily activitiesFree text: Fatigue and lightheadedness and migraines.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-13
- 2021-05-20
- 2021-07-08
- 2021-10-07
-
2021-10-29
Dose 3 — Moderna
-
2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
-
2021-10-31
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-05
- 2021-11-12
- 2021-11-19
- 2021-11-26
- 2021-12-03
- 2021-12-10
- 2022-01-28
-
2022-04-22
Dose 4 — Moderna
- 2022-04-22
-
2022-04-23
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-04-24
-
2022-04-25
Survey response — days 1–6 daily, dose 4MedDRA: Ear pain — Feeling: Fair · Site: Pain · Be unable to do your normal daily activitiesFree text: Pain in right ear. No reason for me to get your pain.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-27
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-04-28
- 2022-04-29
- 2022-05-06
- 2022-05-13
- 2022-05-21
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2022-05-27
Survey response — day 35, dose 4MedDRA: Exposure to SARS-CoV-2, SARS-CoV-2 test negative — Feeling: GoodFree text: I was told that a friend of mine I was in close contact with has COVID-19. So far, I haven't had any symptoms and the at home test was negative. Today has been five days since I was in contact with her so I am going to go get a PCR test.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-05
- 2022-07-22
-
2022-09-28
Dose 5 — Moderna
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2022-09-29
Survey response — days 1–6 daily, dose 5MedDRA: Dysgeusia — Feeling: Poor · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: I had a metallic taste in my mouth shortly after getting the vaccine but it seems to be gone now.MedDRA releases: 2024-11 · check-in free text available
- 2022-09-30
-
2022-10-01
Health check-in — days 1–6 daily, dose 5Feeling: Good · Fever · Fatigue or tirednessAdult check-in
- 2022-10-02
-
2022-10-03
Survey response — days 1–6 daily, dose 5MedDRA: Dysgeusia — Feeling: FairFree text: Metallic taste in mouth for most of the day.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-04
- 2022-10-06
- 2022-10-12
- 2022-10-19
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2022-11-09
Survey response — day 42, dose 5MedDRA: SARS-CoV-2 test positive — 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 visit, Emergency room or emergency department visit, HospitalizationFree text: I tested positive for Covid on October 29.MedDRA releases: 2024-11 · check-in free text available
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2022-11-09
Report sent to call center — day 42, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
-
2022-11-10
Call successfulDoes not wish to fill out VAERS report
- 2022-12-28
- 2023-03-29
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-11 | Moderna | |
| 2 | 2021-04-08 | Moderna | |
| 3 | 2021-10-29 | Moderna | No |
| 4 | 2022-04-22 | Moderna | No |
| 5 | 2022-09-28 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 7 — day 0, dose 2
Systemic reaction (other): It's only been about five hours since my vaccine so the symptoms may appear later.
Release 8 — day 28, dose 2
Symptoms: Fatigue and lightheadedness and migraines.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Pain in right ear. No reason for me to get your pain.
Release 11 — day 35, dose 4
Symptoms: I was told that a friend of mine I was in close contact with has COVID-19. So far, I haven't had any symptoms and the at home test was negative. Today has been five days since I was in contact with her so I am going to go get a PCR test.
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): I had a metallic taste in my mouth shortly after getting the vaccine but it seems to be gone now.
Systemic reaction (other): Metallic taste in mouth for most of the day.
Release 12 — day 42, dose 5
Symptoms: I tested positive for Covid on October 29.
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 | Dizziness | ✓ | ✓ | ✓ |
| SD | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Migraine | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Dysgeusia | · | · | ✓ |
| SRO | Ear pain | · | · | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release