5LJ-69605-93302
5 vaccinations
12 coded responses
50 check-ins
12 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 430 / OH
- Registered
- 2021-01-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-15
Registered in v-safe
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2021-01-15
Dose 1 — Moderna
- 2021-01-15
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2021-01-16
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fever · Chills, Fatigue or tiredness, NauseaAdult check-in
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2021-01-17
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: Pai at injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-18
- 2021-01-19
- 2021-01-21
- 2021-01-22
- 2021-01-29
- 2021-02-05
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2021-02-12
Dose 2 — Moderna
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2021-02-19
Survey response — day 7, dose 2MedDRA: Asthenia, Chills, Fatigue, Throat tightness — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Chills, throat tightening, fatigue, weakness for 2 days following tbe vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-26
- 2021-03-05
- 2021-03-12
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2021-03-19
Survey response — day 35, dose 2MedDRA: Lymphadenopathy, Office visit, Tendonitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Rotator cuff tendinitis, bicep tendinitis, swollen lymph node under arm where injection was given. · Healthcare visit (other): 2 Physician office visits; outpatient therapy.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-19
Report sent to call center — day 35, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-03-26
Survey response — day 42, dose 2MedDRA: Lymphadenopathy, 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: Swollen left lymph node, tendonitis left bicep and rotator cuff.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-26
Report sent to call center — day 42, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-14
- 2021-08-13
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2021-10-26
Dose 3 — Moderna
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2021-10-26
Health check-in — day 0, dose 3Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tirednessAdult check-in
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2021-10-27
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-10-28
Survey response — days 1–6 daily, dose 3MedDRA: Injection site erythema, Injection site reaction, Injection site swelling — Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Raised, red, circular area on arm where injection was given. It is the size of a quarter within the diameter of the severe redness on the arm where the injection was given. The entire deltoild muscle is bright red.MedDRA releases: 2024-11 · check-in free text available
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2021-10-29
Survey response — days 1–6 daily, dose 3MedDRA: Injection site erythema, Injection site pain, Injection site swelling, Urticaria — Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Raised red circular elevation in the red zone where I received the injection. It is the size of a quarter. Tender to touch. No drainage. Resembles a "welt.MedDRA releases: 2024-11 · check-in free text available
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2021-10-30
Survey response — days 1–6 daily, dose 3MedDRA: Injection site reaction, No reaction on previous exposure to drug, Urticaria — Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tirednessFree text: A quarter size, "welt" within the redness in my deltoid muscle where I received the injection. I did not have the welt reaction with the prior two injections.MedDRA releases: 2024-11 · check-in free text available
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2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Injection site erythema, Injection site reaction, Urticaria — Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Quarter size "welt" in injection site present but decreasing in elevation. Degree of redness in deltoid muscle where injrection was given is decreasing. Not as bright in color.MedDRA releases: 2024-11 · check-in free text available
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2021-11-01
Survey response — days 1–6 daily, dose 3MedDRA: Injection site erythema, Injection site reaction, Urticaria — Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Redness of deltoid muscle where the injection was given is less and the "welt" area, which previosly was the size of a quarter is now the size of a dime. Improvement is evident today.MedDRA releases: 2024-11 · check-in free text available
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2021-11-02
Survey response — day 7, dose 3MedDRA: Arthralgia, Injection site erythema, Injection site pain, Injection site reaction, Myalgia, Urticaria — Feeling: Good · Site: Redness, Swelling · Joint pains, Muscle or body achesFree text: The arm of my injection site is less sore and less red. The "welt area" is barely visible. Joint pain and muscle aches still bothersome.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-10
- 2021-11-16
- 2021-11-23
- 2021-11-30
- 2021-12-07
- 2021-12-30
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2021-12-30
Call successfulCompleted over the phone
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2022-01-25
Survey response — 3 months, dose 3MedDRA: Eustachian tube obstruction, Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Sinus infection. Blocked eustachian tube.MedDRA releases: 2024-11 · check-in free text available
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2022-01-25
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-01-27
Call successfulParticipant prefers to complete VAERS report online
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2022-05-19
Dose 4 — Moderna
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2022-05-19
Health check-in — day 0, dose 4Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2022-05-20
Survey response — days 1–6 daily, dose 4MedDRA: Adverse reaction — Feeling: GoodFree text: I ready reported the symptoms I had for about a week following the 4th shot.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-21
- 2022-05-22
- 2022-05-23
- 2022-05-24
- 2022-05-26
- 2022-06-02
- 2022-06-09
- 2022-06-16
- 2022-06-24
- 2022-06-30
- 2022-08-18
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2022-09-15
Dose 5 — Moderna
- 2022-10-10
- 2022-10-13
- 2022-10-20
- 2022-10-27
- 2022-12-15
- 2023-03-16
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Moderna | |
| 2 | 2021-02-12 | Moderna | |
| 3 | 2021-10-26 | Moderna | No |
| 4 | 2022-05-19 | Moderna | No |
| 5 | 2022-09-15 | Moderna | No |
Call center
3 call center cases
3 successful
VAERS report filed, before or during a call: 2
1 wait over 3 months for a first call
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Pai at injection site.
Release 4 — day 7, dose 2
Systemic reaction (other): Chills, throat tightening, fatigue, weakness for 2 days following tbe vaccine.
Release 5 — day 35, dose 2
Symptoms: Rotator cuff tendinitis, bicep tendinitis, swollen lymph node under arm where injection was given.
Healthcare visit (other): 2 Physician office visits; outpatient therapy.
Release 6 — day 42, dose 2
Symptoms: Swollen left lymph node, tendonitis left bicep and rotator cuff.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Raised, red, circular area on arm where injection was given. It is the size of a quarter within the diameter of the severe redness on the arm where the injection was given. The entire deltoild muscle is bright red.
Systemic reaction (other): Raised red circular elevation in the red zone where I received the injection. It is the size of a quarter. Tender to touch. No drainage. Resembles a "welt.
Systemic reaction (other): A quarter size, "welt" within the redness in my deltoid muscle where I received the injection. I did not have the welt reaction with the prior two injections.
Systemic reaction (other): Quarter size "welt" in injection site present but decreasing in elevation. Degree of redness in deltoid muscle where injrection was given is decreasing. Not as bright in color.
Systemic reaction (other): Redness of deltoid muscle where the injection was given is less and the "welt" area, which previosly was the size of a quarter is now the size of a dime. Improvement is evident today.
Release 10 — day 7, dose 3
Systemic reaction (other): The arm of my injection site is less sore and less red. The "welt area" is barely visible. Joint pain and muscle aches still bothersome.
Release 11 — 3 months, dose 3
Symptoms: Sinus infection. Blocked eustachian tube.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): I ready reported the symptoms I had for about a week following the 4th shot.
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 | Eustachian tube obstruction | · | · | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Tendonitis | ✓ | ✓ | ✓ |
| SRO | Adverse reaction | · | · | ✓ |
| SRO | Arthralgia | · | · | ✓ |
| SRO | Asthenia | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Injection site erythema | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site reaction | · | · | ✓ |
| SRO | Injection site swelling | · | · | ✓ |
| SRO | Myalgia | · | · | ✓ |
| SRO | No reaction on previous exposure to drug | · | · | ✓ |
| SRO | Throat tightness | ✓ | ✓ | ✓ |
| SRO | Urticaria | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release