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
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2021-02-05
Dose 1 — Moderna
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2021-03-09
Registered in v-safe
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2021-03-09
Dose 2 — Moderna
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2021-03-09
Survey response — day 0, dose 2MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Shot too rough from person giving vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-10
Survey response — days 1–6 daily, dose 2MedDRA: Headache — Feeling: Good · Site: Pain, ItchingFree text: HeadacheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-12
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body achesAdult check-in
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2021-03-14
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pain, Pain in extremity — Feeling: Fair · Site: Pain, ItchingFree text: My arm still hurts from injection.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-15
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: The shot was given in the wrong spot in arm. Too high on back of armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-16
- 2021-03-23
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2021-03-30
Survey response — day 21, dose 2MedDRA: Pyrexia — Feeling: PoorFree 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
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2021-04-06
Survey response — day 28, dose 2MedDRA: Abdominal pain upper, Pain in extremity, Pyrexia — Feeling: PoorFree text: Leg pain, stomach pain and fever.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-13
Survey response — day 35, dose 2MedDRA: Breast pain, Lymph node pain — Feeling: FairFree text: My breast still hurts and still lymph nodesvunder arm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-20
Survey response — day 42, dose 2MedDRA: Office visit — Feeling: Poor · Be unable to do your normal daily activitiesFree 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
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2021-06-10
Survey response — 3 months, dose 2MedDRA: 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 consultationFree 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
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2021-06-10
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-22
- 2021-09-07
- 2022-03-09
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-05 | Moderna | |
| 2 | 2021-03-09 | Moderna |
Call center
1 call center case
1 unsuccessful
Free text
Release 5 — day 0, dose 2
Systemic reaction (other): Shot too rough from person giving vaccine
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Headache
Systemic reaction (other): My arm still hurts from injection.
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
Symptoms: Run a fever off and on for 3 weeks since vaccine.
Release 7 — day 28, dose 2
Symptoms: Leg pain, stomach pain and fever.
Release 7 — day 35, dose 2
Symptoms: My breast still hurts and still lymph nodesvunder arm.
Release 7 — day 42, dose 2
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
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SD | Abdominal pain upper | ✓ | ✓ | ✓ |
| SD | Breast pain | ✓ | ✓ | ✓ |
| SD | Lymph node pain | ✓ | ✓ | ✓ |
| SD | Office visit | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release