5RA-32282-51117
4 vaccinations
10 coded responses
52 check-ins
9 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 617 / IL
- Registered
- 2021-02-12
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-10
Dose 1 — Moderna
-
2021-02-12
Registered in v-safe
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2021-02-12
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: Soreness at sight of injectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-24
- 2021-03-03
-
2021-03-10
Dose 2 — Moderna
- 2021-03-10
- 2021-03-12
- 2021-03-13
-
2021-03-14
Survey response — days 1–6 daily, dose 2MedDRA: Gingivitis — Feeling: GoodFree text: Gingival irritation and dental painMedDRA 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: Gingival discomfort, Gingival pain — Feeling: FairFree text: Gingival irritation and painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-16
Survey response — days 1–6 daily, dose 2MedDRA: Gingivitis, Office visit, Rash — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Gingival irritation; rash on right hand · Healthcare visit (other): Dental appointment in personMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-16
Report sent to call center — days 1–6 daily, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-17
Survey response — day 7, dose 2MedDRA: Dental discomfort, Gingival discomfort, Gingival pain, Office visit, Rash — Feeling: Fair · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Rash in my right hand has been there a few days. Also gingival irritation and pain when biting on tooth #5 · Healthcare visit (other): Went to the dentist to get a recheck of the dental discomfort I have experienced for the last 5 days. Things are improving.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-17
Report sent to call center — day 7, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-24
- 2021-03-31
- 2021-04-07
- 2021-04-14
- 2021-04-22
- 2021-06-09
- 2021-09-08
-
2021-10-28
Dose 3 — Moderna
- 2021-10-28
-
2021-10-29
Survey response — days 1–6 daily, dose 3MedDRA: Tic — Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Nocturnal ticks that lasted approximately 15 minutesMedDRA releases: 2024-11 · check-in free text available
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-13
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2021-11-18
Survey response — day 21, dose 3MedDRA: Frequent bowel movements, Headache, Nausea — Feeling: FairFree text: I had a headache last night and this morning. Felt nauseous and had several bowel movements in the middle of the night. Still a bit headacheyMedDRA releases: 2024-11 · check-in free text available
- 2021-11-25
- 2021-12-03
- 2021-12-09
-
2021-12-21
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-01-27
-
2022-04-28
Survey response — 6 months, dose 3MedDRA: Influenza — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: I had influenza AMedDRA releases: 2024-11 · check-in free text available
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2022-04-28
Report sent to call center — 6 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-04-29
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-05-06
Dose 4 — Pfizer-BioNTech
- 2022-05-07
- 2022-05-08
- 2022-05-09
- 2022-05-10
- 2022-05-11
- 2022-05-12
-
2022-05-13
Survey response — day 7, dose 4MedDRA: Disorientation, Dizziness — Feeling: GoodFree text: Vague feeling of disorientation and dizzinessMedDRA releases: 2024-11 · check-in free text available
- 2022-05-20
- 2022-05-27
- 2022-06-03
- 2022-06-10
- 2022-06-17
- 2022-08-05
- 2022-11-06
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2023-05-06
Survey response — 12 months, dose 4MedDRA: Office visit, Pain in extremity — Feeling: Fair · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
-
2023-05-06
Report sent to call center — 12 months, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2023-05-08
-
2023-05-09
Callback requested for12:00PM ET
-
2023-05-09
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-10 | Moderna | |
| 2 | 2021-03-10 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
| 4 | 2022-05-06 | Pfizer-BioNTech | No |
Call center
4 call center cases
4 successful
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Soreness at sight of injection
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Gingival irritation and dental pain
Systemic reaction (other): Gingival irritation and pain
Systemic reaction (other): Gingival irritation; rash on right hand
Healthcare visit (other): Dental appointment in person
Release 5 — day 7, dose 2
Systemic reaction (other): Rash in my right hand has been there a few days. Also gingival irritation and pain when biting on tooth #5
Healthcare visit (other): Went to the dentist to get a recheck of the dental discomfort I have experienced for the last 5 days. Things are improving.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Nocturnal ticks that lasted approximately 15 minutes
Release 10 — day 21, dose 3
Symptoms: I had a headache last night and this morning. Felt nauseous and had several bowel movements in the middle of the night. Still a bit headachey
Release 11 — 6 months, dose 3
Symptoms: I had influenza A
Release 11 — day 7, dose 4
Systemic reaction (other): Vague feeling of disorientation and dizziness
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 | Dental discomfort | ✓ | ✓ | ✓ |
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SD | Frequent bowel movements | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SRO | Disorientation | · | · | ✓ |
| SRO | Dizziness | · | · | ✓ |
| SRO | Gingival discomfort | ✓ | ✓ | ✓ |
| SRO | Gingival pain | ✓ | ✓ | ✓ |
| SRO | Gingivitis | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Tic | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release