5SN-33731-30890
3 vaccinations
5 coded responses
37 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 608 / IL
- Registered
- 2021-01-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-29
Registered in v-safe
-
2021-01-29
Dose 1 — Moderna
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2021-01-29
Survey response — day 0, dose 1MedDRA: Discomfort, Immediate post-injection reaction, Limb discomfort, Muscle tightness — Feeling: Good · Site: PainFree text: Arm, neck, and shoulder felt heavy and a little tight right after the injection.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-30
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Redness · Headache, Fatigue or tirednessAdult check-in
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2021-01-31
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-02-02
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2021-02-03
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: FairFree text: DizzinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-05
- 2021-02-12
- 2021-02-20
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2021-02-26
Dose 2 — Moderna
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2021-02-26
Survey response — day 0, dose 2MedDRA: Injection site warmth — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Injection site is warm to the touchMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
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2021-02-28
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-04-03
- 2021-04-09
- 2021-05-28
- 2021-08-27
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2021-12-18
Dose 3 — Moderna
- 2021-12-18
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2021-12-19
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Chills, Fatigue or tirednessAdult check-in
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2021-12-20
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Itching · Fever · ChillsAdult check-in
- 2021-12-21
- 2021-12-24
- 2021-12-25
- 2022-01-01
- 2022-01-08
- 2022-01-15
- 2022-01-24
- 2022-01-29
- 2022-03-19
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2022-06-20
Survey response — 6 months, dose 3MedDRA: Dizziness — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Lightheadedness that lasted roughly 2 weeks. Happened a couple of weeks ago. I don't think this has anything to do with the vaccine.MedDRA releases: 2024-11 · check-in free text available
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2022-06-20
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-06-21
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2022-12-18
Survey response — 12 months, dose 3MedDRA: Ectopic pregnancy, Mechanical urticaria, Surgery, Urticaria — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Ectopic pregnancy w/surgery in august. Dermatographia and idiopathic hives since September.MedDRA releases: 2024-11 · check-in free text available
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2022-12-18
Report sent to call center — 12 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 prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
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2022-12-19
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-12-19
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 | 2021-01-29 | Moderna | |
| 2 | 2021-02-26 | Moderna | |
| 3 | 2021-12-18 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-06-20 | Successful 2022-12-19 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-12-18 | Successful 2022-12-19 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 3 — day 0, dose 1
Systemic reaction (other): Arm, neck, and shoulder felt heavy and a little tight right after the injection.
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Dizziness
Release 4 — day 0, dose 2
Systemic reaction (other): Injection site is warm to the touch
Release 12 — 6 months, dose 3
Symptoms: Lightheadedness that lasted roughly 2 weeks. Happened a couple of weeks ago. I don't think this has anything to do with the vaccine.
Release 12 — 12 months, dose 3
Symptoms: Ectopic pregnancy w/surgery in august. Dermatographia and idiopathic hives since September.
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 | Dizziness | · | · | ✓ |
| SD | Ectopic pregnancy | · | · | ✓ |
| SD | Mechanical urticaria | · | · | ✓ |
| SD | Surgery | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
| SRO | Discomfort | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Injection site warmth | ✓ | ✓ | ✓ |
| SRO | Limb discomfort | ✓ | ✓ | ✓ |
| SRO | Muscle tightness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release