5SZ-25694-58627
4 vaccinations
4 coded responses
22 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 856 / AZ
- Registered
- 2021-02-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-10
Dose 1 — Moderna
-
2021-02-11
Registered in v-safe
-
2021-02-11
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness · Fatigue or tiredness, NauseaAdult check-in
-
2021-02-12
Survey response — days 1–6 daily, dose 1MedDRA: Oropharyngeal pain — Feeling: Fair · Headache, NauseaFree text: Sore throatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-14
- 2021-02-16
- 2021-02-17
- 2021-02-24
- 2021-03-03
-
2021-03-10
Dose 2 — Moderna
-
2021-03-12
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue, Headache, Musculoskeletal stiffness, Pyrexia — Feeling: Good · Site: Pain, Swelling · Fever · Fatigue or tirednessFree text: I was not able to check in yesterday, day after my shot. Had fever to 102, severe fatigue, mild headache and stiffness.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-13
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Swelling, Itching · Fever · Chills, Diarrhea · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-14
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling, Itching · Fatigue or tiredness, NauseaAdult check-in
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-24
- 2021-03-31
- 2021-04-07
-
2021-04-16
Survey response — day 35, dose 2MedDRA: Headache — Feeling: FairFree text: Mild headaches on left side, mainly in the afternoon, but not long lasting or even bad enough to take a pill. Probably nothing.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-09
Survey response — 3 months, dose 2MedDRA: Chest pain, Musculoskeletal pain, Office visit, Pain — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Pain in my shoulder blade radiating around to my chest, sharp and frequent for a few weeks but mostly gone now. · Healthcare visit (other): Routine annual wellness visit followed by many testsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-09
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-08
-
2021-10-27
Dose 3 — Moderna
-
2021-11-21
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-04-07
Dose 4 — Moderna
- 2022-04-26
- 2022-05-12
- 2022-10-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-10 | Moderna | |
| 2 | 2021-03-10 | Moderna | |
| 3 | 2021-10-27 | Moderna | No |
| 4 | 2022-04-07 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Sore throat
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): I was not able to check in yesterday, day after my shot. Had fever to 102, severe fatigue, mild headache and stiffness.
Release 7 — day 35, dose 2
Symptoms: Mild headaches on left side, mainly in the afternoon, but not long lasting or even bad enough to take a pill. Probably nothing.
Release 9 — 3 months, dose 2
Symptoms: Pain in my shoulder blade radiating around to my chest, sharp and frequent for a few weeks but mostly gone now.
Healthcare visit (other): Routine annual wellness visit followed by many tests
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 | Chest pain | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Musculoskeletal pain | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | · | ✓ |
| SRO | Musculoskeletal stiffness | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release