5NQ-15690-80089
3 vaccinations
4 coded responses
26 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 471 / IN
- Registered
- 2021-03-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-16
Registered in v-safe
-
2021-03-16
Dose 1 — Moderna
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-30
-
2021-04-06
Survey response — day 21, dose 1MedDRA: Arthralgia — Feeling: Good · Be unable to do your normal daily activitiesFree text: My knee pain has been worseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-13
-
2021-04-15
Dose 2 — Moderna
-
2021-04-20
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Erythema, Nausea, Pain, Pyrexia, Swelling — Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: I had nausea, diarrhea, chills, fever, redness and swelling, and body aches that were mlderate to severe from the 16th-18thMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-21
- 2021-04-22
- 2021-04-29
- 2021-05-06
- 2021-05-13
-
2021-05-20
Survey response — day 35, dose 2MedDRA: Arthritis, Condition aggravated, Office visit, Pre-existing disease — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: My spinal degenerative disc disease and knee degeneration from arthritis are getting worse. Being sent for a second opinion at a new pain management doctor. · Healthcare visit (other): Saw my orthopedic surgeon for steroid injections in knee and pain management dor third epidural shot in lower spine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-20
Report sent to call center — day 35, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-27
- 2021-07-15
-
2021-09-20
Dose 3 — Moderna
- 2021-10-14
- 2021-10-30
- 2021-11-01
-
2021-12-20
Survey response — 3 months, dose 3MedDRA: Viral infection — Feeling: Poor · 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: I caught a virus that's been going around.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-20
Report sent to call center — 3 months, dose 3Be 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)
-
2021-12-21
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-03-21
- 2022-09-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-16 | Moderna | |
| 2 | 2021-04-15 | Moderna | |
| 3 | 2021-09-20 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 7 — day 21, dose 1
Symptoms: My knee pain has been worse
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): I had nausea, diarrhea, chills, fever, redness and swelling, and body aches that were mlderate to severe from the 16th-18th
Release 8 — day 35, dose 2
Symptoms: My spinal degenerative disc disease and knee degeneration from arthritis are getting worse. Being sent for a second opinion at a new pain management doctor.
Healthcare visit (other): Saw my orthopedic surgeon for steroid injections in knee and pain management dor third epidural shot in lower spine.
Release 10 — 3 months, dose 3
Symptoms: I caught a virus that's been going around.
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 | Arthralgia | ✓ | ✓ | ✓ |
| SD | Arthritis | ✓ | ✓ | ✓ |
| SD | Condition aggravated | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Viral infection | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Swelling | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release