66F-20124-09768
5 vaccinations
6 coded responses
39 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 193 / PA
- Registered
- 2021-10-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-17
Dose 1 — Moderna
-
2021-04-20
Dose 2 — Moderna
-
2021-10-26
Dose 3 — Moderna
-
2021-10-28
Registered in v-safe
- 2021-10-28
- 2021-10-29
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2021-10-30
Survey response — days 1–6 daily, dose 3MedDRA: Lymph node pain, Musculoskeletal chest pain — Feeling: GoodFree text: Yesterday, I felt periodic sharp pinching feeling in the back right rib but I don't notice it today. Also, yesterday, I felt like my glands were a little sore under my jaw but I don't feel that anymore either.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Alopecia, Medical counselling, Stress — Feeling: GoodFree text: I had concern about my Alopecia returning after the booster. I was diagnosed with alopecia areata five days after my second shot but my doctors felt that stress was the trigger. I never had it before.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-01
- 2021-11-02
- 2021-11-09
- 2021-11-16
- 2021-11-23
- 2021-11-30
- 2021-12-07
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2022-01-25
Survey response — 3 months, dose 3MedDRA: Small intestinal obstruction — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Small bowel obstructionMedDRA releases: 2024-11 · check-in free text available
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2022-01-25
Report sent to call center — 3 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · Hospitalization · 1 call case(s)
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2022-01-26
Call successfulDoes not wish to fill out VAERS report
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2022-04-19
Dose 4 — Moderna
-
2022-04-19
Health check-in — day 0, dose 4Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-04-20
- 2022-04-21
- 2022-04-22
- 2022-04-23
- 2022-04-24
- 2022-04-25
- 2022-04-26
- 2022-05-03
- 2022-05-10
- 2022-05-17
- 2022-05-24
- 2022-05-31
- 2022-07-19
-
2022-09-07
Dose 5 — Moderna
-
2022-09-08
Survey response — days 1–6 daily, dose 5MedDRA: Ear pain — Feeling: Good · Site: Pain · Headache, Fatigue or tirednessFree text: Mild earacheMedDRA releases: 2024-11 · check-in free text available
- 2022-09-09
- 2022-09-10
- 2022-09-11
- 2022-09-12
- 2022-09-14
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2022-09-21
Survey response — day 14, dose 5MedDRA: Arthralgia — Feeling: FairFree text: Slightly achy jointsMedDRA releases: 2024-11 · check-in free text available
- 2022-09-28
- 2022-10-05
- 2022-10-12
- 2022-10-19
- 2022-12-07
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2023-03-10
Survey response — 6 months, dose 5MedDRA: Atrial fibrillation — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitMedDRA releases: 2024-11
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2023-03-10
Report sent to call center — 6 months, dose 5Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
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2023-03-14
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 | 2021-03-17 | Moderna | No |
| 2 | 2021-04-20 | Moderna | No |
| 3 | 2021-10-26 | Moderna | No |
| 4 | 2022-04-19 | Moderna | No |
| 5 | 2022-09-07 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Yesterday, I felt periodic sharp pinching feeling in the back right rib but I don't notice it today. Also, yesterday, I felt like my glands were a little sore under my jaw but I don't feel that anymore either.
Systemic reaction (other): I had concern about my Alopecia returning after the booster. I was diagnosed with alopecia areata five days after my second shot but my doctors felt that stress was the trigger. I never had it before.
Release 11 — 3 months, dose 3
Symptoms: Small bowel obstruction
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Mild earache
Release 12 — day 14, dose 5
Symptoms: Slightly achy joints
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 | Arthralgia | · | · | ✓ |
| SD | Atrial fibrillation | · | · | ✓ |
| SD | Small intestinal obstruction | · | · | ✓ |
| SRO | Alopecia | · | · | ✓ |
| SRO | Ear pain | · | · | ✓ |
| SRO | Lymph node pain | · | · | ✓ |
| SRO | Medical counselling | · | · | ✓ |
| SRO | Musculoskeletal chest pain | · | · | ✓ |
| SRO | Stress | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release