5WY-11335-03250
1 vaccination
6 coded responses
8 check-ins
6 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 342 / FL
- Registered
- 2021-03-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-11
Dose 1 — Moderna
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2021-03-13
Registered in v-safe
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2021-03-13
Survey response — days 1–6 daily, dose 1MedDRA: Confusional state, Movement disorder, Pain — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): 2bd day pain severe and could hardly move all parts of body · Healthcare visit (other): Couldnt drive cause of severe pain & confusionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-13
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-03-14
Survey response — days 1–6 daily, dose 1MedDRA: Confusional state, Dizziness, Somnolence — Feeling: Fair · Site: Pain, Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: Confusion, dizziness, sleepinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-15
Survey response — days 1–6 daily, dose 1MedDRA: Pain — Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activitiesFree text: Pain WAS all over body but today is mostly all on left sideMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-18
Survey response — day 7, dose 1MedDRA: Injection site swelling — Feeling: Fair · Site: Swelling · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesFree text: The swelling is not on the shot site but under it about six inches longMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-26
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2021-04-01
Survey response — day 21, dose 1MedDRA: Joint swelling, Office visit, Peripheral swelling — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Not sure connected but both feet and ankles swollen for three days · Healthcare visit (other): Dr visitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-01
Report sent to call center — day 21, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-04-08
Survey response — day 28, dose 1MedDRA: Joint swelling, Office visit, Peripheral swelling — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Swollen feet and ankles. Swollen for 3 days and ice and elevation didnt help. Finally went away but after couple days swelled again · Healthcare visit (other): In officeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-08
Report sent to call center — day 28, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-08
- 2021-06-08
- 2021-06-08
- 2021-06-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-11 | Moderna |
Call center
3 call center cases
3 unsuccessful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): 2bd day pain severe and could hardly move all parts of body
Healthcare visit (other): Couldnt drive cause of severe pain & confusion
Systemic reaction (other): Confusion, dizziness, sleepiness
Systemic reaction (other): Pain WAS all over body but today is mostly all on left side
Release 5 — day 7, dose 1
Systemic reaction (other): The swelling is not on the shot site but under it about six inches long
Release 6 — day 21, dose 1
Symptoms: Not sure connected but both feet and ankles swollen for three days
Healthcare visit (other): Dr visit
Release 7 — day 28, dose 1
Symptoms: Swollen feet and ankles. Swollen for 3 days and ice and elevation didnt help. Finally went away but after couple days swelled again
Healthcare visit (other): In office
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 | Confusional state | ✓ | ✓ | ✓ |
| HCVO | Office visit | ✓ | ✓ | ✓ |
| HCVO | Pain | ✓ | ✓ | ✓ |
| SD | Joint swelling | ✓ | ✓ | ✓ |
| SD | Peripheral swelling | ✓ | ✓ | ✓ |
| SRO | Confusional state | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Injection site swelling | ✓ | ✓ | ✓ |
| SRO | Movement disorder | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Somnolence | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release