5PU-11797-97197
2 vaccinations
5 coded responses
22 check-ins
5 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 481 / MI
- Registered
- 2021-04-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-04-01
Registered in v-safe
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2021-04-01
Dose 1 — Moderna
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2021-04-01
Survey response — day 0, dose 1MedDRA: Fatigue — Feeling: GoodFree text: TiredMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
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2021-04-15
Survey response — day 14, dose 1MedDRA: Eye irritation, Eye pain, Fatigue, Lacrimation increased — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Left eye has started to burn/sting and then tear up on and off all day today. Extra tired yesterday and tidayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-22
Survey response — day 21, dose 1MedDRA: Arthralgia, Hyperaesthesia — Feeling: FairFree text: Left shoulder/upper has become sore again as if I just got the vaccine. It is also sensitive to the touchMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-29
Dose 2 — Moderna
- 2021-04-29
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2021-04-30
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pain, Pain — Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: The pain from injection site shoots down my arm to my fingersMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tiredness, DiarrheaAdult check-in
- 2021-05-03
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2021-05-04
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-05-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache · Be unable to do your normal daily activitiesAdult check-in
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2021-05-06
Health check-in — day 7, dose 2Feeling: Fair · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-05-13
Survey response — day 14, dose 2MedDRA: Injected limb mobility decreased, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activitiesFree text: The left arm (injection arm) is extremely sore, actually hurts continuously and it's difficult moving higher than halfway up.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-20
- 2021-05-27
- 2021-06-03
- 2021-06-10
- 2021-07-29
- 2021-10-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-01 | Moderna | |
| 2 | 2021-04-29 | Moderna |
Free text
Release 6 — day 0, dose 1
Systemic reaction (other): Tired
Release 7 — day 14, dose 1
Symptoms: Left eye has started to burn/sting and then tear up on and off all day today. Extra tired yesterday and tiday
Release 7 — day 21, dose 1
Symptoms: Left shoulder/upper has become sore again as if I just got the vaccine. It is also sensitive to the touch
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): The pain from injection site shoots down my arm to my fingers
Release 8 — day 14, dose 2
Symptoms: The left arm (injection arm) is extremely sore, actually hurts continuously and it's difficult moving higher than halfway up.
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 | Arthralgia | ✓ | ✓ | ✓ |
| SD | Eye irritation | ✓ | ✓ | ✓ |
| SD | Eye pain | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Hyperaesthesia | ✓ | ✓ | ✓ |
| SD | Injected limb mobility decreased | ✓ | ✓ | ✓ |
| SD | Lacrimation increased | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release