5VA-41719-79207
4 vaccinations
9 coded responses
45 check-ins
9 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 782 / TX
- Registered
- 2021-01-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-08
Dose 1 — Moderna
-
2021-01-09
Registered in v-safe
- 2021-01-09
- 2021-01-11
- 2021-01-14
- 2021-01-15
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2021-01-22
Survey response — day 14, dose 1MedDRA: Abdominal pain upper, Breast mass, Lymphadenopathy, Mammogram abnormal, Medical counselling, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Stomach ache for two days. No diarrhea, or nausea just terrible cramps after eating. Also, routine mammogram came back prominent lymph node in right breast area/axilla for ultra sound follow- up. Is it related to Moderna Covid vaccine? · Healthcare visit (other): Dr.Prescribed famotidine 20 mg and Senior-S because thought more related to constipation & my acid reflux than vaccine. Also had routine mammogram & Dr wants follow-up ultra sound dilute to prominent lymph node in right breast area/axilla. Could this be related to Moderna Covid shot? Always had pretty routine mammogramsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-22
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-01-29
- 2021-02-05
-
2021-02-11
Dose 2 — Moderna
-
2021-02-12
Survey response — days 1–6 daily, dose 2MedDRA: Adverse reaction — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Nausea, Abdominal pain · Be unable to do your normal daily activitiesFree text: From 10:30 pm last night to 12:30am symptoms were very uncomfortable and finall fell asleep at 1:30am.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-13
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling · Muscle or body achesAdult check-in
-
2021-02-14
Survey response — days 1–6 daily, dose 2MedDRA: Feeling jittery — Feeling: Fair · Chills, HeadacheFree text: Jittery part of the morning like electrified or nerve sensitivity.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-15
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · NoneAdult check-in
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2021-02-16
Survey response — days 1–6 daily, dose 2MedDRA: Abdominal pain upper, Noninfective gingivitis, Stomatitis — Feeling: Fair · Headache, Joint pains, Abdominal painFree text: Stomach cramps today. Also mouth sores like canker sores on gum line.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-17
- 2021-02-18
- 2021-02-25
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-03-31
-
2021-04-01
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-05-13
- 2021-08-12
-
2021-10-26
Dose 3 — Moderna
- 2021-10-26
-
2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: Insomnia, Malaise — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Nausea, Abdominal painFree text: Did not sleep last night and really felt worse with the booster more than prior 2 covid shotsMedDRA releases: 2024-11 · check-in free text available
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2021-10-28
Survey response — days 1–6 daily, dose 3MedDRA: Cardiomegaly, Electrocardiogram abnormal, Office visit, Pre-existing disease — Feeling: Fair · Muscle or body achesFree text: Was at routine Dr visit and Dr noticed after doing ekg than heart enlargement in one chamber and wants an echo done. Is this a possible reaction or just my heart murmur acting up that I've had all my life?MedDRA releases: 2024-11 · check-in free text available
- 2021-10-29
-
2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Joint pains, Muscle or body achesAdult check-in
- 2021-10-31
- 2021-11-01
-
2021-11-02
Survey response — day 7, dose 3MedDRA: Cold sweat, Feeling hot, Syncope — Feeling: Poor · Fatigue or tiredness, NauseaFree text: Had a slight fainting episode and became very hot and clammy.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-09
- 2021-11-16
- 2021-11-23
- 2021-11-30
- 2021-12-07
- 2022-01-25
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2022-04-15
Dose 4 — Moderna
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2022-04-18
Survey response — days 1–6 daily, dose 4MedDRA: Arthralgia, Influenza like illness, Malaise, Self-medication — Feeling: Fair · Site: Redness, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: The day after I got the 2nd Moderna booster I was very sick. It was like I had a super flu. I took Pepto Bismo & took extra strength Tylenol every 6 hrs. The 2nd day I felt better but a few joint aches remained.MedDRA releases: 2024-11 · check-in free text available
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2022-04-19
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
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2022-04-20
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2022-04-21
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
-
2022-04-22
Survey response — day 7, dose 4MedDRA: Nasal congestion, Oral herpes — Feeling: Fair · Chills, Headache, Fatigue or tirednessFree text: Cold sore on upper lip and inside nose membrane swellingMedDRA releases: 2024-11 · check-in free text available
- 2022-04-29
- 2022-05-06
- 2022-05-13
- 2022-05-20
- 2022-05-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-08 | Moderna | |
| 2 | 2021-02-11 | Moderna | |
| 3 | 2021-10-26 | Moderna | No |
| 4 | 2022-04-15 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 2 — day 14, dose 1
Symptoms: Stomach ache for two days. No diarrhea, or nausea just terrible cramps after eating. Also, routine mammogram came back prominent lymph node in right breast area/axilla for ultra sound follow- up. Is it related to Moderna Covid vaccine?
Healthcare visit (other): Dr.Prescribed famotidine 20 mg and Senior-S because thought more related to constipation & my acid reflux than vaccine. Also had routine mammogram & Dr wants follow-up ultra sound dilute to prominent lymph node in right breast area/axilla. Could this be related to Moderna Covid shot? Always had pretty routine mammograms
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): From 10:30 pm last night to 12:30am symptoms were very uncomfortable and finall fell asleep at 1:30am.
Systemic reaction (other): Jittery part of the morning like electrified or nerve sensitivity.
Systemic reaction (other): Stomach cramps today. Also mouth sores like canker sores on gum line.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Did not sleep last night and really felt worse with the booster more than prior 2 covid shots
Systemic reaction (other): Was at routine Dr visit and Dr noticed after doing ekg than heart enlargement in one chamber and wants an echo done. Is this a possible reaction or just my heart murmur acting up that I've had all my life?
Release 10 — day 7, dose 3
Systemic reaction (other): Had a slight fainting episode and became very hot and clammy.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): The day after I got the 2nd Moderna booster I was very sick. It was like I had a super flu. I took Pepto Bismo & took extra strength Tylenol every 6 hrs. The 2nd day I felt better but a few joint aches remained.
Release 11 — day 7, dose 4
Systemic reaction (other): Cold sore on upper lip and inside nose membrane swelling
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 | Breast mass | ✓ | ✓ | ✓ |
| HCVO | Lymphadenopathy | ✓ | ✓ | ✓ |
| HCVO | Medical counselling | ✓ | ✓ | ✓ |
| HCVO | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Abdominal pain upper | ✓ | ✓ | ✓ |
| SD | Breast mass | ✓ | ✓ | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SD | Mammogram abnormal | ✓ | ✓ | ✓ |
| SRO | Abdominal pain upper | ✓ | ✓ | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Arthralgia | · | · | ✓ |
| SRO | Cardiomegaly | · | · | ✓ |
| SRO | Cold sweat | · | · | ✓ |
| SRO | Electrocardiogram abnormal | · | · | ✓ |
| SRO | Feeling hot | · | · | ✓ |
| SRO | Feeling jittery | ✓ | ✓ | ✓ |
| SRO | Influenza like illness | · | · | ✓ |
| SRO | Insomnia | · | · | ✓ |
| SRO | Malaise | · | · | ✓ |
| SRO | Nasal congestion | · | · | ✓ |
| SRO | Noninfective gingivitis | ✓ | ✓ | ✓ |
| SRO | Office visit | · | · | ✓ |
| SRO | Oral herpes | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Self-medication | · | · | ✓ |
| SRO | Stomatitis | ✓ | ✓ | ✓ |
| SRO | Syncope | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release