5XX-11060-09039
4 vaccinations
10 coded responses
54 check-ins
9 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 857 / AZ
- Registered
- 2021-01-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-28
Registered in v-safe
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2021-01-28
Dose 1 — Moderna
- 2021-01-28
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2021-01-29
Survey response — days 1–6 daily, dose 1MedDRA: Self-medication — Feeling: Good · Site: Pain · Headache, Fatigue or tirednessFree text: I am taking TylenolMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-30
Survey response — days 1–6 daily, dose 1MedDRA: Pain, Swelling — Feeling: Good · Site: Pain, SwellingFree text: Even tho there is slight swelling and pain..no Tylenol today. It is not that badMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
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2021-02-11
Survey response — day 14, dose 1MedDRA: Injection site discolouration, Injection site erythema, Injection site pain, Injection site swelling, Pyrexia — Feeling: GoodFree text: Arm became red and swollen at injection site on day 14(approx 4) Slight feverish at site..but Minimal painTurned lighter pink now..less feverish and swollen.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-18
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2021-02-25
Dose 2 — Moderna
- 2021-02-25
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2021-02-26
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Fatigue or tirednessAdult check-in
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2021-02-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Itching · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-02-28
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tirednessAdult check-in
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2021-03-01
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tirednessAdult check-in
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2021-03-02
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Redness, Itching · Headache, Fatigue or tirednessAdult check-in
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2021-03-03
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Redness, Itching · Headache, Fatigue or tirednessAdult check-in
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-04-01
- 2021-04-08
- 2021-05-27
- 2021-08-26
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2021-11-02
Dose 3 — Moderna
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2021-11-03
Survey response — days 1–6 daily, dose 3MedDRA: Asthenia, Fatigue — Feeling: Poor · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Just tired feeling no energyMedDRA releases: 2024-11 · check-in free text available
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2021-11-04
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesAdult check-in
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2021-11-05
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-11-07
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesAdult check-in
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2021-11-08
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Swelling · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-11-09
Health check-in — day 7, dose 3Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-11-16
- 2021-11-23
- 2021-11-30
- 2021-12-07
- 2021-12-14
- 2022-02-01
- 2022-05-03
-
2022-05-22
Dose 4 — Moderna
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2022-05-22
Survey response — day 0, dose 4MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2024-11 · check-in free text available
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2022-05-23
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2022-05-24
Survey response — days 1–6 daily, dose 4MedDRA: Headache, Self-medication — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tirednessFree text: Taking Tylenol for the headacheMedDRA releases: 2024-11 · check-in free text available
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2022-05-25
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
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2022-05-26
Survey response — days 1–6 daily, dose 4MedDRA: Self-medication — Feeling: Fair · Site: Swelling, Itching · Muscle or body aches, Fatigue or tirednessFree text: Taking Tylenol as neededMedDRA releases: 2024-11 · check-in free text available
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2022-05-27
Survey response — days 1–6 daily, dose 4MedDRA: Self-medication — Feeling: Fair · Headache, Fatigue or tirednessFree text: Taking Tylenol and rest between activitiesMedDRA releases: 2024-11 · check-in free text available
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2022-05-28
Survey response — days 1–6 daily, dose 4MedDRA: Headache, Self-medication — Feeling: Fair · Headache, Fatigue or tirednessFree text: Still taking tylenol for headache but is much betterMedDRA releases: 2024-11 · check-in free text available
- 2022-05-29
- 2022-06-07
- 2022-06-12
- 2022-06-19
- 2022-06-26
- 2022-07-03
- 2022-08-21
- 2022-11-20
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2023-05-22
Survey response — 12 months, dose 4MedDRA: Ear discomfort, Office visit, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
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2023-05-22
Call case (no matching report) — SuccessfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2023-05-23
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2023-05-23
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-28 | Moderna | |
| 2 | 2021-02-25 | Moderna | |
| 3 | 2021-11-02 | Moderna | No |
| 4 | 2022-05-22 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): I am taking Tylenol
Systemic reaction (other): Even tho there is slight swelling and pain..no Tylenol today. It is not that bad
Release 4 — day 14, dose 1
Symptoms: Arm became red and swollen at injection site on day 14(approx 4) Slight feverish at site..but Minimal painTurned lighter pink now..less feverish and swollen.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Just tired feeling no energy
Release 11 — day 0, dose 4
Systemic reaction (other): No
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Taking Tylenol for the headache
Systemic reaction (other): Taking Tylenol as needed
Systemic reaction (other): Taking Tylenol and rest between activities
Systemic reaction (other): Still taking tylenol for headache but is much better
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 | Ear discomfort | · | · | ✓ |
| SD | Injection site discolouration | ✓ | ✓ | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Injection site swelling | ✓ | ✓ | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Asthenia | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | No adverse event | · | · | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Swelling | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release