5Z5-15894-62538
2 vaccinations
8 coded responses
26 check-ins
8 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 970 / OR
- Registered
- 2021-01-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-09
Registered in v-safe
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2021-01-09
Dose 1 — Moderna
- 2021-01-09
- 2021-01-10
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2021-01-11
Survey response — days 1–6 daily, dose 1MedDRA: Lymphadenopathy, Swollen tongue — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Swollen submandibular lump nodes both sides. Slight posterior tongue swelling near the base on lateral borders.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-12
Survey response — days 1–6 daily, dose 1MedDRA: Swollen tongue — Feeling: Good · Site: PainFree text: Tongue still sligg DH rly swollen on posterior lateral borders.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-13
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-23
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2021-01-30
Survey response — day 21, dose 1MedDRA: Headache, Heart rate increased — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Headache in frontal portion of my head. Rapid heart beat earlier today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-06
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2021-02-07
Dose 2 — Moderna
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2021-02-08
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness, Swelling · Fever · 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
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2021-02-09
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
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2021-02-10
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Good · Site: PainFree text: Left infraorbital notch, plus lower lid margin and surrounding skinMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-11
Survey response — days 1–6 daily, dose 2MedDRA: Eyelid infection — Feeling: GoodFree text: Left lower eyelid infectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-12
Survey response — days 1–6 daily, dose 2MedDRA: Eyelid infection — Feeling: GoodFree text: Left lower eyelid infectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-13
Survey response — days 1–6 daily, dose 2MedDRA: Eyelid infection — Feeling: GoodFree text: Left eyelid infectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-14
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2021-02-21
Survey response — day 14, dose 2MedDRA: Headache — Feeling: Good · Be unable to workFree text: Headache on Wednesday, Thursday, and Friday that started mid morning and lasted until about 4:00 each day.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-28
- 2021-03-07
- 2021-03-14
- 2021-03-21
- 2021-05-09
- 2021-08-08
- 2022-02-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-09 | Moderna | |
| 2 | 2021-02-07 | Moderna |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Swollen submandibular lump nodes both sides. Slight posterior tongue swelling near the base on lateral borders.
Systemic reaction (other): Tongue still sligg DH rly swollen on posterior lateral borders.
Release 3 — day 21, dose 1
Symptoms: Headache in frontal portion of my head. Rapid heart beat earlier today.
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Left infraorbital notch, plus lower lid margin and surrounding skin
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Left lower eyelid infection
Systemic reaction (other): Left lower eyelid infection
Systemic reaction (other): Left eyelid infection
Release 4 — day 14, dose 2
Symptoms: Headache on Wednesday, Thursday, and Friday that started mid morning and lasted until about 4:00 each day.
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 | ✓ | ✓ | ✓ |
| SD | Heart rate increased | ✓ | ✓ | ✓ |
| SRO | Eyelid infection | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Mandibular mass | ○ | ○ | ○ |
| SRO | Swollen tongue | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release