5Y5-33140-71115
2 vaccinations
6 coded responses
21 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 152 / PA
- Registered
- 2021-03-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-11
Dose 1 — Moderna
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2021-03-13
Registered in v-safe
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2021-03-13
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Chills, Fatigue or tirednessAdult check-in
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2021-03-14
Survey response — days 1–6 daily, dose 1MedDRA: Pain in extremity, Self-medication — Feeling: Good · Site: Itching · ChillsFree text: Forgot to report. On day after shot. My arm hurt so much , I took a pain reliever. I am a chef. I put in a full day of work. Thought perhaps lifting trays could have effected the shot area.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-15
Health check-in — days 1–6 daily, dose 1Feeling: Good · Chills, Fatigue or tirednessAdult check-in
- 2021-03-16
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2021-03-17
Survey response — days 1–6 daily, dose 1MedDRA: Feeling abnormal — Feeling: Fair · Fatigue or tirednessFree text: Feel kind of foggy today. Not quite moderate, but more than mild. Had to work today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-18
- 2021-03-25
- 2021-04-04
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2021-04-08
Dose 2 — Moderna
- 2021-04-08
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2021-04-09
Survey response — days 1–6 daily, dose 2MedDRA: Pre-existing disease, Sinus disorder — Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesFree text: I have asthma and my sinuses seem to be bothering meMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-10
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-04-11
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Chills, Headache, Joint pains, Fatigue or tiredness, NauseaAdult check-in
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2021-04-12
Survey response — days 1–6 daily, dose 2MedDRA: Dyspnoea — Feeling: Fair · Fatigue or tirednessFree text: Feeling winded after climbing stairsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-13
Survey response — days 1–6 daily, dose 2MedDRA: Cough — Feeling: Fair · Headache, Muscle or body achesFree text: Cough at timesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-15
- 2021-04-24
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2021-05-01
Survey response — day 21, dose 2MedDRA: Headache — Feeling: FairFree text: Chronic headaches. Had them after both shots. I still go about my day, however, quite noticeable in the day and overnightMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-15
- 2021-05-22
- 2021-07-08
- 2021-10-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-11 | Moderna | |
| 2 | 2021-04-08 | Moderna |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Forgot to report. On day after shot. My arm hurt so much , I took a pain reliever. I am a chef. I put in a full day of work. Thought perhaps lifting trays could have effected the shot area.
Systemic reaction (other): Feel kind of foggy today. Not quite moderate, but more than mild. Had to work today.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): I have asthma and my sinuses seem to be bothering me
Systemic reaction (other): Feeling winded after climbing stairs
Systemic reaction (other): Cough at times
Release 8 — day 21, dose 2
Symptoms: Chronic headaches. Had them after both shots. I still go about my day, however, quite noticeable in the day and overnight
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 | Headache | ✓ | ✓ | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Sinus disorder | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release