5YJ-33745-85058
4 vaccinations
5 coded responses
26 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 920 / CA
- Registered
- 2021-03-17
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-06
Dose 1 — Moderna
-
2021-03-16
Dose 2 — Moderna
-
2021-03-17
Registered in v-safe
-
2021-03-17
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tirednessFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-18
Survey response — days 1–6 daily, dose 2MedDRA: Tenderness — Feeling: Good · Site: PainFree text: Arm just sore when touched not on movementMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-19
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-24
- 2021-03-30
- 2021-04-06
- 2021-04-13
- 2021-04-20
- 2021-04-27
- 2021-06-15
- 2021-09-14
-
2021-11-02
Dose 3 — Moderna
-
2022-03-16
Survey response — 12 months, dose 2MedDRA: Deafness, Tinnitus, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: I was diagnosed with tinnitus and slight high frequency hearing loss. Could be just age related but it did occur after vaccination. Either way I'm fine. It is a small price to pay to be safe and healthy. · Healthcare visit (other): Made appointment with audiologistMedDRA releases: 2024-11 · check-in free text available
-
2022-03-16
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2022-03-18
Call successfulCompleted over the phone
-
2022-05-01
Dose 4 — Moderna
-
2022-05-05
Survey response — days 1–6 daily, dose 4MedDRA: Fatigue, Pain, Pain in extremity, Reaction to previous exposure to any vaccine, Tinnitus — Feeling: Fair · Site: Pain, ItchingFree text: About 8hrs after shot my tinnitus, (which started after my 2nd shot in March) became louder for a day. I also was tired with body aches and my arm pain was more moderate. Feel much better today. Got the vaccine on 5/1.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-06
- 2022-05-08
- 2022-05-15
- 2022-05-22
- 2022-05-31
- 2022-06-05
- 2022-06-12
- 2022-07-31
-
2022-10-30
Survey response — 6 months, dose 4MedDRA: Unevaluable event — Feeling: Good · Be unable to do your normal daily activitiesFree text: Got the latest booster on October 13, 2022. ModernaMedDRA releases: 2024-11 · check-in free text available
- 2023-05-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-06 | Moderna | |
| 2 | 2021-03-16 | Moderna | |
| 3 | 2021-11-02 | Moderna | No |
| 4 | 2022-05-01 | Moderna | No |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): No
Systemic reaction (other): Arm just sore when touched not on movement
Release 11 — 12 months, dose 2
Symptoms: I was diagnosed with tinnitus and slight high frequency hearing loss. Could be just age related but it did occur after vaccination. Either way I'm fine. It is a small price to pay to be safe and healthy.
Healthcare visit (other): Made appointment with audiologist
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): About 8hrs after shot my tinnitus, (which started after my 2nd shot in March) became louder for a day. I also was tired with body aches and my arm pain was more moderate. Feel much better today. Got the vaccine on 5/1.
Release 12 — 6 months, dose 4
Symptoms: Got the latest booster on October 13, 2022. Moderna
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 | Unevaluable event | · | · | ✓ |
| SD | Deafness | · | · | ✓ |
| SD | Tinnitus | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
| SRO | Reaction to previous exposure to any vaccine | · | · | ✓ |
| SRO | Tenderness | ✓ | ✓ | ✓ |
| SRO | Tinnitus | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release