5RJ-31577-73601
4 vaccinations
3 coded responses
28 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 448 / OH
- Registered
- 2020-12-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-28
Registered in v-safe
-
2020-12-28
Dose 1 — Moderna
- 2020-12-28
- 2020-12-29
- 2020-12-30
- 2020-12-31
- 2021-01-01
- 2021-01-02
-
2021-01-03
Survey response — days 1–6 daily, dose 1MedDRA: Vertigo — Feeling: FairFree text: VertigoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-04
- 2021-01-11
- 2021-01-18
-
2021-01-25
Dose 2 — Moderna
- 2021-01-25
-
2021-01-26
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling, Itching · HeadacheAdult check-in
-
2021-01-27
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling, Itching · HeadacheAdult check-in
-
2021-01-28
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling, Itching · HeadacheAdult check-in
- 2021-01-29
- 2021-01-30
- 2021-01-31
-
2021-02-01
Health check-in — day 7, dose 2Feeling: Good · Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-08
- 2021-02-18
- 2021-02-22
- 2021-03-01
- 2021-03-08
-
2021-04-26
Survey response — 3 months, dose 2MedDRA: Arthralgia, Hypoaesthesia, Injection site reaction, Massage, Nervous system disorder, Office visit, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Nerve issues in arm where vaccine was given. Shoulder back and front and mid back rib area. Numbness in little finger and Leung finger. Pain in elbow and forearm. Been going on since March 2nd. Do not know if its relates or not but its the left · Healthcare visit (other): GP twice. Massage therapist twice and chiropractor twice.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-26
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)
-
2021-07-26
Survey response — 6 months, dose 2MedDRA: Fatigue, Hypersomnia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Extreme exhaustion. Sleeping way too much. Taking naps a lot that I never took before. Im just in very tired a lot and I have not changed anything within my lifestyle to warrant this.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-12-23
Dose 3 — Moderna
- 2022-01-25
-
2022-04-07
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-07-25
Dose 4 — Moderna
- 2022-10-24
- 2023-01-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Moderna | |
| 2 | 2021-01-25 | Moderna | |
| 3 | 2021-12-23 | Moderna | No |
| 4 | 2022-07-25 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Vertigo
Release 8 — 3 months, dose 2
Symptoms: Nerve issues in arm where vaccine was given. Shoulder back and front and mid back rib area. Numbness in little finger and Leung finger. Pain in elbow and forearm. Been going on since March 2nd. Do not know if its relates or not but its the left
Healthcare visit (other): GP twice. Massage therapist twice and chiropractor twice.
Release 9 — 6 months, dose 2
Symptoms: Extreme exhaustion. Sleeping way too much. Taking naps a lot that I never took before. Im just in very tired a lot and I have not changed anything within my lifestyle to warrant this.
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 | Massage | ✓ | ✓ | ✓ |
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | · | ✓ |
| SD | Hypersomnia | ✓ | · | ✓ |
| SD | Hypoaesthesia | ✓ | ✓ | ✓ |
| SD | Injection site reaction | ✓ | ✓ | ✓ |
| SD | Nervous system disorder | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Vertigo | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release