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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

  1. 2021-04-01
    Registered in v-safe
  2. 2021-04-01
    Dose 1 — Moderna
  3. 2021-04-01
    Survey response — day 0, dose 1
    MedDRA: Fatigue — Feeling: Good
    Free text: Tired
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-04-04
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  5. 2021-04-05
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-04-06
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Headache
    Adult check-in
  7. 2021-04-07
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-04-08
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-04-15
    Survey response — day 14, dose 1
    MedDRA: Eye irritation, Eye pain, Fatigue, Lacrimation increased — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Left eye has started to burn/sting and then tear up on and off all day today. Extra tired yesterday and tiday
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-04-22
    Survey response — day 21, dose 1
    MedDRA: Arthralgia, Hyperaesthesia — Feeling: Fair
    Free text: Left shoulder/upper has become sore again as if I just got the vaccine. It is also sensitive to the touch
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-04-29
    Dose 2 — Moderna
  12. 2021-04-29
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  13. 2021-04-30
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site pain, Pain — Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: The pain from injection site shoots down my arm to my fingers
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-05-01
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Fatigue or tiredness, Diarrhea
    Adult check-in
  15. 2021-05-03
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-05-04
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  17. 2021-05-05
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Headache · Be unable to do your normal daily activities
    Adult check-in
  18. 2021-05-06
    Health check-in — day 7, dose 2
    Feeling: Fair · Chills, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  19. 2021-05-13
    Survey response — day 14, dose 2
    MedDRA: Injected limb mobility decreased, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities
    Free 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
  20. 2021-05-20
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-05-27
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-06-03
    Health check-in — day 35, dose 2
    Feeling: Fair
    Adult check-in
  23. 2021-06-10
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in
  24. 2021-07-29
    Health check-in — 3 months, dose 2
    Feeling: Fair
    Adult check-in
  25. 2021-10-30
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-04-01Moderna
22021-04-29Moderna

Free text

Release 6 — day 0, dose 1

2021-04-01

Systemic reaction (other): Tired

Release 7 — day 14, dose 1

2021-04-15

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

2021-04-22

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

2021-04-30

Systemic reaction (other): The pain from injection site shoots down my arm to my fingers

Release 8 — day 14, dose 2

2021-05-13

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

FieldPreferred term2021-092023-042024-11
SDArthralgia ✓ ✓ ✓
SDEye irritation ✓ ✓ ✓
SDEye pain ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDHyperaesthesia ✓ ✓ ✓
SDInjected limb mobility decreased ✓ ✓ ✓
SDLacrimation increased ✓ ✓ ✓
SDPain in extremity ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SROPain ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release