5MR-32860-53328
2 vaccinations
12 coded responses
18 check-ins
12 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 480 / MI
- Registered
- 2021-02-14
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-02-12
Dose 1 — Moderna
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2021-02-14
Registered in v-safe
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2021-02-15
Survey response — days 1–6 daily, dose 1MedDRA: Constipation, Dry mouth, Lip dry — Feeling: Fair · Site: Pain · Be unable to do your normal daily activitiesFree text: Extreme dry mouth and lips. Unusual constipation.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-16
Survey response — days 1–6 daily, dose 1MedDRA: Constipation, Dry mouth, Flatulence, Lip dry — Feeling: GoodFree text: Mild dryness of mouth and lips. Milder Constipation and gasMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-17
Survey response — days 1–6 daily, dose 1MedDRA: Flatulence — Feeling: Good · Abdominal painFree text: GasMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-18
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2021-02-21
Survey response — day 7, dose 1MedDRA: Abdominal discomfort — Feeling: GoodFree text: Some stomach discomfort stillMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-26
Survey response — day 14, dose 1MedDRA: Abdominal discomfort, Flatulence, Pre-existing disease, Thirst — Feeling: GoodFree text: Stomach discomfort and gas continues but better. No extreme feeling for water but feeling of need for water which is abnormal for me. Only time I every felt need for water was during an unusual cold with muscle pain and extreme thrist pre-Sar-cov PanMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-07
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2021-03-12
Dose 2 — Moderna
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-19
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2021-03-26
Survey response — day 14, dose 2MedDRA: Axillary pain, Oedema peripheral — Feeling: FairFree text: Painful right Armpit that is visibly swollenMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-03
Survey response — day 21, dose 2MedDRA: Discomfort, Limb discomfort, Oedema peripheral — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Right Armpit still swollen causing arm arm & hand discomfort. Not as physically noticeable as last week.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-10
Survey response — day 28, dose 2MedDRA: Pain, Peripheral swelling, Tenderness — Feeling: FairFree text: Hand affected with arm movement. Right arm swelling, ache and tenderness moved from underarm to back outer arm and currently at lower outer arm. Turn and soar to touch. Left lower leg muscle flutter spasm unexpectedly.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-17
Survey response — day 35, dose 2MedDRA: Chest pain, Pain in extremity, Peripheral swelling — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Arm pain and swelling because non-existing 04/14/2020. Thought reporting system was for directing me. I will check in with my pcp on covid-19 related issues. Thanks · Healthcare visit (other): May mention of pain in upper left chest . . after first shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-17
Report sent to call center — day 35, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-06-14
Survey response — 3 months, dose 2MedDRA: Cyanosis, Pain in extremity, Peripheral arterial occlusive disease — Feeling: Poor · Be unable to work or attend school, 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: Fluttering in legs progressed to pain and aches in legs. Diagnosed with PAD for the first time. From time to time out of the blue having sensations in arm(s) and/or legs(s) . .MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-14
Report sent to call center — 3 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2021-06-21
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2021-09-10
Survey response — 6 months, dose 2MedDRA: Dyspnoea, Gingival discomfort, Pain in extremity, Sensory disturbance — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Leg/thigh Pain, shortness of breath, and arm & leg sensations, unusual gum irritations ...MedDRA releases: 2024-11 · check-in free text available
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2022-03-12
Survey response — 12 months, dose 2MedDRA: Angiopathy, Pain — Feeling: Poor · 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 visitFree text: Vascular problems and extreme pain. . .MedDRA releases: 2024-11 · check-in free text available
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2022-03-12
Report sent to call center — 12 months, dose 2Be 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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2022-03-14
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-12 | Moderna | |
| 2 | 2021-03-12 | Moderna |
Call center
3 call center cases
3 successful
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Extreme dry mouth and lips. Unusual constipation.
Systemic reaction (other): Mild dryness of mouth and lips. Milder Constipation and gas
Systemic reaction (other): Gas
Release 4 — day 7, dose 1
Systemic reaction (other): Some stomach discomfort still
Release 4 — day 14, dose 1
Symptoms: Stomach discomfort and gas continues but better. No extreme feeling for water but feeling of need for water which is abnormal for me. Only time I every felt need for water was during an unusual cold with muscle pain and extreme thrist pre-Sar-cov Pan cut off by CDC
Release 6 — day 14, dose 2
Symptoms: Painful right Armpit that is visibly swollen
Release 6 — day 21, dose 2
Symptoms: Right Armpit still swollen causing arm arm & hand discomfort. Not as physically noticeable as last week.
Release 7 — day 28, dose 2
Symptoms: Hand affected with arm movement. Right arm swelling, ache and tenderness moved from underarm to back outer arm and currently at lower outer arm. Turn and soar to touch. Left lower leg muscle flutter spasm unexpectedly.
Release 7 — day 35, dose 2
Symptoms: Arm pain and swelling because non-existing 04/14/2020. Thought reporting system was for directing me. I will check in with my pcp on covid-19 related issues. Thanks
Healthcare visit (other): May mention of pain in upper left chest . . after first shot.
Release 9 — 3 months, dose 2
Symptoms: Fluttering in legs progressed to pain and aches in legs. Diagnosed with PAD for the first time. From time to time out of the blue having sensations in arm(s) and/or legs(s) . .
Release 9 — 6 months, dose 2
Symptoms: Leg/thigh Pain, shortness of breath, and arm & leg sensations, unusual gum irritations ...
Release 11 — 12 months, dose 2
Symptoms: Vascular problems and extreme pain. . .
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 | Chest pain | ✓ | ✓ | ✓ |
| SD | Abdominal discomfort | ✓ | ✓ | ✓ |
| SD | Angiopathy | · | · | ✓ |
| SD | Axillary pain | ✓ | ✓ | ✓ |
| SD | Cyanosis | ✓ | ✓ | ✓ |
| SD | Discomfort | ✓ | ✓ | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Flatulence | ✓ | ✓ | ✓ |
| SD | Gingival discomfort | · | · | ✓ |
| SD | Limb discomfort | ✓ | ✓ | ✓ |
| SD | Oedema peripheral | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Peripheral arterial occlusive disease | ✓ | ✓ | ✓ |
| SD | Peripheral swelling | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | · | ✓ |
| SD | Sensory disturbance | · | · | ✓ |
| SD | Tenderness | ✓ | ✓ | ✓ |
| SD | Thirst | ✓ | ✓ | ✓ |
| SRO | Abdominal discomfort | ✓ | ✓ | ✓ |
| SRO | Constipation | ✓ | ✓ | ✓ |
| SRO | Dry mouth | ✓ | ✓ | ✓ |
| SRO | Flatulence | ✓ | ✓ | ✓ |
| SRO | Lip dry | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release