5LA-30339-39153
5 vaccinations
17 coded responses
51 check-ins
15 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 531 / WI
- Registered
- 2021-01-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-01-12
Registered in v-safe
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2021-01-12
Dose 1 — Moderna
- 2021-01-12
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2021-01-13
Survey response — days 1–6 daily, dose 1MedDRA: Pruritus — Feeling: Fair · Site: Pain, Itching · Headache · Be unable to do your normal daily activitiesFree text: The itching is now further down my arm, a bit past my elbow.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-13
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
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2021-01-14
Survey response — days 1–6 daily, dose 1MedDRA: Headache, Myalgia — Feeling: Good · Site: PainFree text: I've had headache and muscle pain BUT these were pains I had prior to the vaccine, therefore unrelated.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-16
Survey response — days 1–6 daily, dose 1MedDRA: Myalgia, Pain — Feeling: Good · Muscle or body achesFree text: No but you should know that the muscle/body aches that I have are pretty typical for me even without a vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-17
Survey response — days 1–6 daily, dose 1MedDRA: Headache, Migraine — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Left sided headache/migraineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-17
Report sent to call center — days 1–6 daily, dose 1Be unable to do your normal daily activities1 call case(s)
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2021-01-18
Survey response — days 1–6 daily, dose 1MedDRA: Headache, Pre-existing disease — Feeling: Good · HeadacheFree text: (The headache may be related not to the vaccine but to my chronic issueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-19
- 2021-01-26
- 2021-02-02
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2021-02-09
Dose 2 — Moderna
- 2021-02-09
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2021-02-10
Survey response — days 1–6 daily, dose 2MedDRA: Nasal congestion, Nasal dryness — Feeling: Poor · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Dry stuffy noseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-11
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy — Feeling: FairFree text: Swollen supraclavicular lymph nodes on same side as shot in armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-12
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy — Feeling: GoodFree text: The supraclavicular lymph node pain and swelling has greatly reduced and is now mild and tolerable.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-13
- 2021-02-14
- 2021-02-15
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2021-02-18
Survey response — day 7, dose 2MedDRA: Headache, Pre-existing disease — Feeling: Good · HeadacheFree text: The headache is likely NOT related to the shot. I am Very prone to headachesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-23
Survey response — day 14, dose 2MedDRA: Abdominal pain upper — Feeling: GoodFree text: Stomach pain for a day or two, but perhaps it was due to something I ate?MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-02
Survey response — day 21, dose 2MedDRA: Ear pain, Fatigue, Oropharyngeal pain — Feeling: GoodFree text: Left sided throat and left ear pain for approx 3 days ending about 2 days ago. Then very fatigued. But the ear and throat pain seemed like it might be allergy related.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-09
- 2021-03-18
- 2021-03-23
- 2021-05-11
- 2021-08-12
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2021-11-07
Dose 3 — Moderna
- 2021-11-22
- 2021-11-28
- 2021-12-05
- 2021-12-12
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2021-12-19
Survey response — day 42, dose 3MedDRA: Cough, Pre-existing disease — Feeling: FairFree text: A chronic cough precovid cough is slightly worse.MedDRA releases: 2024-11 · check-in free text available
- 2022-02-06
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2022-04-15
Dose 4 — Moderna
- 2022-04-19
- 2022-04-20
- 2022-04-21
- 2022-04-24
- 2022-05-01
- 2022-05-08
- 2022-05-13
- 2022-05-29
- 2022-07-17
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2022-10-07
Dose 5 — ModernaCo-administered: Flu
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2022-10-08
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-10-09
- 2022-10-10
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2022-10-11
Survey response — days 1–6 daily, dose 5MedDRA: Bone pain, Pre-existing disease — Feeling: GoodFree text: Left thigh bone pain, but this was occurring intermittently prior to vaccination, as well.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-12
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2022-10-13
Survey response — days 1–6 daily, dose 5MedDRA: Pre-existing disease — Feeling: Good · Headache, Fatigue or tirednessFree text: No but FYI the headache and fatigue were occurring before the vaccination.MedDRA releases: 2024-11 · check-in free text available
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2022-10-14
Health check-in — day 7, dose 5Feeling: Fair · Headache · Be unable to do your normal daily activitiesAdult check-in
- 2022-10-21
- 2022-10-30
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2022-11-04
Survey response — day 28, dose 5MedDRA: Hypoaesthesia, Muscle atrophy, Muscle twitching, Myalgia, Paraesthesia, Tongue movement disturbance, Tremor — 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: Worsening muscle pain & atrophy in back muscles, shakiness, twitching in tongue & left shoulder, & intermittent numbness and tingling in parts of extremities. I have no idea what is causing these symptoms. They've been going on for many months.MedDRA releases: 2024-11 · check-in free text available
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2022-11-04
Report sent to call center — day 28, dose 5Be 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)
- 2022-11-07
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2023-01-09
Survey response — 3 months, dose 5MedDRA: Muscle twitching — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
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2023-01-09
Report sent to call center — 3 months, dose 5Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-01-10
- 2023-01-10
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2023-04-07
Survey response — 6 months, dose 5MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
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2023-04-07
Report sent to call center — 6 months, dose 5Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
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2023-04-12
Call successfulParticipant prefers to complete VAERS report online
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2023-04-12
Call successfulParticipant prefers to complete VAERS report online
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2023-04-12
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-12 | Moderna | |
| 2 | 2021-02-09 | Moderna | |
| 3 | 2021-11-07 | Moderna | No |
| 4 | 2022-04-15 | Moderna | No |
| 5 | 2022-10-07 | Moderna | Flu |
Call center
5 call center cases
3 successful · 2 priority 2/3 (triaged and no follow up)
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): The itching is now further down my arm, a bit past my elbow.
Systemic reaction (other): I've had headache and muscle pain BUT these were pains I had prior to the vaccine, therefore unrelated.
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): No but you should know that the muscle/body aches that I have are pretty typical for me even without a vaccine.
Systemic reaction (other): Left sided headache/migraine
Systemic reaction (other): (The headache may be related not to the vaccine but to my chronic issue
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Dry stuffy nose
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Swollen supraclavicular lymph nodes on same side as shot in arm
Systemic reaction (other): The supraclavicular lymph node pain and swelling has greatly reduced and is now mild and tolerable.
Release 4 — day 7, dose 2
Systemic reaction (other): The headache is likely NOT related to the shot. I am Very prone to headaches
Release 4 — day 14, dose 2
Symptoms: Stomach pain for a day or two, but perhaps it was due to something I ate?
Release 4 — day 21, dose 2
Symptoms: Left sided throat and left ear pain for approx 3 days ending about 2 days ago. Then very fatigued. But the ear and throat pain seemed like it might be allergy related.
Release 10 — day 42, dose 3
Symptoms: A chronic cough precovid cough is slightly worse.
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Left thigh bone pain, but this was occurring intermittently prior to vaccination, as well.
Systemic reaction (other): No but FYI the headache and fatigue were occurring before the vaccination.
Release 12 — day 28, dose 5
Symptoms: Worsening muscle pain & atrophy in back muscles, shakiness, twitching in tongue & left shoulder, & intermittent numbness and tingling in parts of extremities. I have no idea what is causing these symptoms. They've been going on for many months.
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 | Abdominal pain upper | ✓ | ✓ | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Ear pain | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Hypoaesthesia | · | · | ✓ |
| SD | Muscle atrophy | · | · | ✓ |
| SD | Muscle twitching | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Paraesthesia | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Tongue movement disturbance | · | · | ✓ |
| SD | Tremor | · | · | ✓ |
| SRO | Bone pain | · | · | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Migraine | ✓ | ✓ | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
| SRO | Nasal congestion | ✓ | ✓ | ✓ |
| SRO | Nasal dryness | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release