5WD-14690-56550
2 vaccinations
3 coded responses
26 check-ins
3 free-text entries
2 call cases
- Sex
- —
- Age at first dose
- 36-40
- ZIP prefix
- 021 / MA
- Registered
- 2021-01-24
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-24
Registered in v-safe
-
2021-01-24
Dose 1 — Moderna
- 2021-01-24
-
2021-01-25
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
-
2021-02-07
Survey response — day 14, dose 1MedDRA: Injection site erythema, Injection site pain, Injection site rash, Injection site reaction, Injection site swelling — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Day 9-11 I had a rash at injection site with worsened redness, swelling, pain, burning and itching. Rash extended 4-5 inch in diameter. Improved on days 12-13 and now back to normal. Was told by PCP this was a harmless Moderna reaction.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-07
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-14
-
2021-02-21
Dose 2 — Moderna
- 2021-02-21
-
2021-02-22
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-02-23
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-24
Survey response — days 1–6 daily, dose 2MedDRA: Tachycardia — Feeling: GoodFree text: Unusual tachycardia and narrow pulse pressure every evening since receiving vaccine. Messaged cardiologist and waiting for responseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-25
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-07
- 2021-03-14
- 2021-03-21
- 2021-03-28
- 2021-04-04
- 2021-05-23
-
2021-07-15
Call successfulDoes not wish to fill out VAERS report
- 2021-08-22
-
2022-02-21
Survey response — 12 months, dose 2MedDRA: Fibromuscular dysplasia — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Diagnosis of fibromuscular dysplasiaMedDRA releases: 2024-11 · check-in free text available
-
2022-02-21
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-02-22
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-24 | Moderna | |
| 2 | 2021-02-21 | Moderna |
Call center
2 call center cases
2 successful
Free text
Release 3 — day 14, dose 1
Symptoms: Day 9-11 I had a rash at injection site with worsened redness, swelling, pain, burning and itching. Rash extended 4-5 inch in diameter. Improved on days 12-13 and now back to normal. Was told by PCP this was a harmless Moderna reaction.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Unusual tachycardia and narrow pulse pressure every evening since receiving vaccine. Messaged cardiologist and waiting for response
Release 11 — 12 months, dose 2
Symptoms: Diagnosis of fibromuscular dysplasia
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 | Fibromuscular dysplasia | · | · | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SD | Injection site reaction | ✓ | ✓ | ✓ |
| SD | Injection site swelling | ✓ | ✓ | ✓ |
| SRO | Tachycardia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release