5SG-25860-00025
4 vaccinations
5 coded responses
46 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 531 / WI
- Registered
- 2021-01-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-12
Dose 1 — Moderna
-
2021-01-13
Registered in v-safe
- 2021-01-14
- 2021-01-16
- 2021-01-18
- 2021-01-21
- 2021-01-26
-
2021-02-02
Survey response — day 21, dose 1MedDRA: Chills, Fatigue, Headache — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Experiencing a very rare headache & chills. No fever. No SOB. PO2 steady but lower 90's. No cough. No sore throat. Very tired dispute a fairly good night's sleep. I'm 85. Wear a mask. Social distancing. Hand hygiene. Mostly stay home.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-09
Dose 2 — Moderna
- 2021-02-09
- 2021-02-10
-
2021-02-11
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · NoneAdult check-in
- 2021-02-12
-
2021-02-13
Health check-in — days 1–6 daily, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-14
- 2021-02-15
- 2021-02-18
- 2021-02-23
- 2021-03-04
- 2021-03-09
- 2021-08-10
-
2021-11-09
Dose 3 — Moderna
- 2021-11-09
- 2021-11-11
-
2021-11-12
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Joint pains, Fatigue or tirednessAdult check-in
- 2021-11-13
- 2021-11-14
- 2021-11-15
- 2021-11-16
- 2021-11-23
- 2021-11-30
- 2021-12-07
- 2021-12-16
-
2021-12-21
Survey response — day 42, dose 3MedDRA: Abdominal distension, Defaecation urgency, Diarrhoea, Nausea — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Nausea, bloating, loose stools with urgency.MedDRA releases: 2024-11 · check-in free text available
-
2022-02-08
Survey response — 3 months, dose 3MedDRA: Dyspnoea, Fatigue — Feeling: Fair · 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: Tire very easily for past six weeks plus short of breath with only mild exercise.MedDRA releases: 2024-11 · check-in free text available
-
2022-02-08
Report sent to call center — 3 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-03-24
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-05-10
-
2022-05-19
Dose 4 — Moderna
- 2022-05-19
-
2022-05-20
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
-
2022-05-21
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-05-22
- 2022-05-23
- 2022-05-24
-
2022-05-25
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-05-26
- 2022-06-02
- 2022-06-09
- 2022-06-16
-
2022-06-23
Survey response — day 35, dose 4MedDRA: Injection site erythema, Injection site pain, Injection site rash, Injection site swelling — Feeling: FairFree text: Weird as it seems, I developed a strange, small, localized tiny and painful to touch raised red and tiny oozing rash directly over the injection site. I thought it might be a bug bite. Not so sure. Took a selfie of the site. I'm a retired RN.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-30
-
2023-05-19
Survey response — 12 months, dose 4MedDRA: Knee arthroplasty, Surgery — 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 · HospitalizationMedDRA releases: 2024-11
-
2023-05-19
Report sent to call center — 12 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prHospitalization · 1 call case(s)
-
2023-05-22
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-12 | Moderna | |
| 2 | 2021-02-09 | Moderna | |
| 3 | 2021-11-09 | Moderna | No |
| 4 | 2022-05-19 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 3 — day 21, dose 1
Symptoms: Experiencing a very rare headache & chills. No fever. No SOB. PO2 steady but lower 90's. No cough. No sore throat. Very tired dispute a fairly good night's sleep. I'm 85. Wear a mask. Social distancing. Hand hygiene. Mostly stay home.
Release 10 — day 42, dose 3
Symptoms: Nausea, bloating, loose stools with urgency.
Release 11 — 3 months, dose 3
Symptoms: Tire very easily for past six weeks plus short of breath with only mild exercise.
Release 12 — day 35, dose 4
Symptoms: Weird as it seems, I developed a strange, small, localized tiny and painful to touch raised red and tiny oozing rash directly over the injection site. I thought it might be a bug bite. Not so sure. Took a selfie of the site. I'm a retired RN.
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 | Surgery | · | · | ✓ |
| SD | Abdominal distension | · | · | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Defaecation urgency | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Injection site erythema | · | · | ✓ |
| SD | Injection site pain | · | · | ✓ |
| SD | Injection site rash | · | · | ✓ |
| SD | Injection site swelling | · | · | ✓ |
| SD | Knee arthroplasty | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release