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5QM-20724-63918

2 vaccinations 9 coded responses 14 check-ins 9 free-text entries 1 call case
Sex
Female
Age at first dose
66+
ZIP prefix
641 / MO
Registered
2021-03-09
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-05
    Dose 1 — Moderna
  2. 2021-03-09
    Registered in v-safe
  3. 2021-03-09
    Dose 2 — Moderna
  4. 2021-03-09
    Survey response — day 0, dose 2
    MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Shot too rough from person giving vaccine
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-10
    Survey response — days 1–6 daily, dose 2
    MedDRA: Headache — Feeling: Good · Site: Pain, Itching
    Free text: Headache
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-03-12
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Headache, Muscle or body aches
    Adult check-in
  7. 2021-03-14
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site pain, Pain in extremity — Feeling: Fair · Site: Pain, Itching
    Free text: My arm still hurts from injection.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-03-15
    Survey response — days 1–6 daily, dose 2
    MedDRA: Unevaluable event — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: The shot was given in the wrong spot in arm. Too high on back of arm
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-03-16
    Health check-in — day 7, dose 2
    Feeling: Fair · Site: Itching · None
    Adult check-in
  10. 2021-03-23
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  11. 2021-03-30
    Survey response — day 21, dose 2
    MedDRA: Pyrexia — Feeling: Poor
    Free text: Run a fever off and on for 3 weeks since vaccine.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-04-06
    Survey response — day 28, dose 2
    MedDRA: Abdominal pain upper, Pain in extremity, Pyrexia — Feeling: Poor
    Free text: Leg pain, stomach pain and fever.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-04-13
    Survey response — day 35, dose 2
    MedDRA: Breast pain, Lymph node pain — Feeling: Fair
    Free text: My breast still hurts and still lymph nodesvunder arm.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-04-20
    Survey response — day 42, dose 2
    MedDRA: Office visit — Feeling: Poor · Be unable to do your normal daily activities
    Free text: The pain in my arm has gone into my shoulder. Terrible pain in arm, shoulder, back and neck. Thought pain should be gone not gotten worse. Made appointment with doctor for next week.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-06-10
    Survey response — 3 months, dose 2
    MedDRA: Office visit, Pain, Respiratory tract congestion — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Symptoms: Awful congestion. Aches and pains. Something going on for months now. · Healthcare visit (other): Dr. Office.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-06-10
    Report sent to call center — 3 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  17. 2021-06-22
  18. 2021-09-07
    Health check-in — 6 months, dose 2
    Feeling: Fair
    Adult check-in
  19. 2022-03-09
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-05Moderna
22021-03-09Moderna

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 5 — day 0, dose 2

2021-03-09

Systemic reaction (other): Shot too rough from person giving vaccine

Release 5 — days 1–6 daily, dose 2

2021-03-10

Systemic reaction (other): Headache

2021-03-14

Systemic reaction (other): My arm still hurts from injection.

2021-03-15

Systemic reaction (other): The shot was given in the wrong spot in arm. Too high on back of arm

Release 6 — day 21, dose 2

2021-03-30

Symptoms: Run a fever off and on for 3 weeks since vaccine.

Release 7 — day 28, dose 2

2021-04-06

Symptoms: Leg pain, stomach pain and fever.

Release 7 — day 35, dose 2

2021-04-13

Symptoms: My breast still hurts and still lymph nodesvunder arm.

Release 7 — day 42, dose 2

2021-04-20

Symptoms: The pain in my arm has gone into my shoulder. Terrible pain in arm, shoulder, back and neck. Thought pain should be gone not gotten worse. Made appointment with doctor for next week.

Release 9 — 3 months, dose 2

2021-06-10

Symptoms: Awful congestion. Aches and pains. Something going on for months now.
Healthcare visit (other): Dr. Office.

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
HCVOOffice visit ✓ ✓ ✓
SDAbdominal pain upper ✓ ✓ ✓
SDBreast pain ✓ ✓ ✓
SDLymph node pain ✓ ✓ ✓
SDOffice visit ✓ ✓ ✓
SDPain ✓ ✓ ✓
SDPain in extremity ✓ ✓ ✓
SDPyrexia ✓ ✓ ✓
SDRespiratory tract congestion ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROUnevaluable event ✓ ✓ ✓

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