5S5-12251-70620
4 vaccinations
5 coded responses
47 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 129 / NY
- Registered
- 2021-01-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
ZAF-10956-05770
Child or adolescent in my care · Male · 2021-10-26
CKU-14402-10865
Child or adolescent in my care · Male · 2021-11-08
Timeline
-
2021-01-12
Registered in v-safe
-
2021-01-12
Dose 1 — Moderna
- 2021-01-12
- 2021-01-13
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-26
- 2021-02-02
-
2021-02-09
Dose 2 — Moderna
- 2021-02-09
-
2021-02-10
Survey response — days 1–6 daily, dose 2MedDRA: Abdominal pain — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessFree text: Stomach has been a little off, but I wouldnt call it abdominal pain.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-11
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-23
-
2021-03-02
Survey response — day 21, dose 2MedDRA: Pain in extremity — Feeling: GoodFree text: My left arm, especially the forearm, is extremely achy & sore. It started a few days after my first dose, but wasnt bad and I assumed had nothing to do with the vaccine. Its been getting worse every week. Not sure if its related to the vacciMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-09
-
2021-03-16
Survey response — day 35, dose 2MedDRA: Pain in extremity — Feeling: GoodFree text: Very sore forearm (left) - feels like possible tendonitis.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-23
- 2021-05-11
-
2021-08-10
Survey response — 6 months, dose 2MedDRA: Inflammation, Pain in extremity, Peripheral swelling — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Swollen, inflamed, painful left ball of my foot.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-10
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-17
-
2021-11-10
Dose 3 — Moderna
- 2021-11-11
- 2021-11-12
- 2021-11-13
- 2021-11-14
- 2021-11-15
- 2021-11-16
- 2021-11-17
- 2021-11-24
- 2021-12-01
- 2021-12-08
- 2021-12-15
- 2021-12-22
- 2022-02-09
- 2022-05-11
-
2022-09-15
Dose 4 — Moderna
- 2022-09-22
- 2022-09-29
- 2022-10-06
- 2022-10-13
-
2022-10-20
Survey response — day 35, dose 4MedDRA: Amenorrhoea, Hot flush — Feeling: FairFree text: Hot flashes, no menstrual cycle since my latest booster.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-30
- 2022-12-15
- 2023-03-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-12 | Moderna | |
| 2 | 2021-02-09 | Moderna | |
| 3 | 2021-11-10 | Moderna | No |
| 4 | 2022-09-15 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Stomach has been a little off, but I wouldnt call it abdominal pain.
Release 4 — day 21, dose 2
Symptoms: My left arm, especially the forearm, is extremely achy & sore. It started a few days after my first dose, but wasnt bad and I assumed had nothing to do with the vaccine. Its been getting worse every week. Not sure if its related to the vacci
Release 5 — day 35, dose 2
Symptoms: Very sore forearm (left) - feels like possible tendonitis.
Release 9 — 6 months, dose 2
Symptoms: Swollen, inflamed, painful left ball of my foot.
Release 12 — day 35, dose 4
Symptoms: Hot flashes, no menstrual cycle since my latest booster.
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 |
|---|---|---|---|---|
| SD | Amenorrhoea | · | · | ✓ |
| SD | Hot flush | · | · | ✓ |
| SD | Inflammation | ✓ | · | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Peripheral swelling | ✓ | · | ✓ |
| SRO | Abdominal pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release