5SV-76145-28868
2 vaccinations
5 coded responses
17 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 365 / AL
- Registered
- 2021-03-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-02
Dose 1 — Moderna
-
2021-03-22
Registered in v-safe
- 2021-03-22
- 2021-03-23
-
2021-03-30
Dose 2 — Moderna
-
2021-03-30
Survey response — day 0, dose 2MedDRA: No adverse event — Feeling: GoodFree text: It has only been one hour so symptoms may change.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-31
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-04-01
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-02
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-04-03
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-04-04
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-04-06
Health check-in — day 7, dose 2Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-13
- 2021-04-20
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2021-04-27
Survey response — day 28, dose 2MedDRA: Fatigue, Paranasal sinus discomfort, Paranasal sinus hypersecretion — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Sinus pressure and drainage Extreme fatigueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-04
- 2021-05-11
- 2021-06-29
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2021-09-30
Survey response — 6 months, dose 2MedDRA: Arthritis reactive, Malaise, Muscular weakness, Office visit, Oropharyngeal pain, Somnolence, Tendonitis, Uveitis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Reactive arthritis (suspected)Tendon inflammation General malaise and feeling unwellUveitis Sore throat Muscle weakness Somnolence · Healthcare visit (other): Orthopedic doctor, gynecologistMedDRA releases: 2024-11 · check-in free text available
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2021-09-30
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)
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2021-12-03
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2022-03-30
Survey response — 12 months, dose 2MedDRA: Arthralgia, Brain fog, Malaise, Pyrexia, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Received an additional booster because I had a cortisone shot. The vaccine gave me fever and severe joint pain for 2 to 3 days. I was very sick but had negative covid test. Joint pain is still present. Have increased brain fog.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-02 | Moderna | |
| 2 | 2021-03-30 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 6 — day 0, dose 2
Systemic reaction (other): It has only been one hour so symptoms may change.
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): No
Release 8 — day 28, dose 2
Symptoms: Sinus pressure and drainage Extreme fatigue
Release 9 — 6 months, dose 2
Symptoms: Reactive arthritis (suspected)Tendon inflammation General malaise and feeling unwellUveitis Sore throat Muscle weakness Somnolence
Healthcare visit (other): Orthopedic doctor, gynecologist
Release 11 — 12 months, dose 2
Symptoms: Received an additional booster because I had a cortisone shot. The vaccine gave me fever and severe joint pain for 2 to 3 days. I was very sick but had negative covid test. Joint pain is still present. Have increased brain fog.
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 | Office visit | · | · | ✓ |
| SD | Arthralgia | · | · | ✓ |
| SD | Arthritis reactive | · | · | ✓ |
| SD | Brain fog | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Muscular weakness | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Paranasal sinus discomfort | ✓ | ✓ | ✓ |
| SD | Paranasal sinus hypersecretion | ✓ | ✓ | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Somnolence | · | · | ✓ |
| SD | Tendonitis | · | · | ✓ |
| SD | Uveitis | · | · | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release