69K-23188-45801
4 vaccinations
9 coded responses
51 check-ins
6 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 957 / CA
- Registered
- 2021-02-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Registered dependents
SPW-19752-08744
Child or adolescent in my care · Female · 2021-12-04
3QP-32129-40752
Child or adolescent in my care · Male · 2022-12-29
Timeline
-
2021-02-04
Registered in v-safe
-
2021-02-04
Dose 1 — Moderna
- 2021-02-04
- 2021-02-05
-
2021-02-06
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Itching · Fever · Headache, Fatigue or tirednessAdult check-in
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-11
-
2021-02-18
Survey response — day 14, dose 1MedDRA: Immunisation reaction, Injection site erythema, Injection site pain — Feeling: GoodFree text: Covid arm. Red & tenderness at injection site after 1 week.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-25
-
2021-03-04
Dose 2 — Moderna
- 2021-03-04
-
2021-03-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Itching · Fatigue or tirednessAdult check-in
-
2021-03-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Redness · Fever · Fatigue or tirednessAdult check-in
-
2021-03-07
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Itching · Fatigue or tirednessAdult check-in
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-04-01
- 2021-04-08
- 2021-04-15
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2021-06-03
Survey response — 3 months, dose 2MedDRA: Injected limb mobility decreased, Injection site pain, Office visit, Pain — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: For 2months my upper arm where vaccine was injected i have had pain with certain movements. I have some limited range of motion on that arm since my covid shot as well. · Healthcare visit (other): Visit to primary physician. Ultrasound was made, all was normal. But continue with the problemMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-03
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-02
-
2021-12-29
Dose 3 — Moderna
- 2021-12-29
- 2021-12-30
-
2022-01-01
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Muscle or body achesAdult check-in
-
2022-01-02
Survey response — days 1–6 daily, dose 3MedDRA: Breast discomfort, Discomfort — Feeling: GoodFree text: Arm pit and side of breast discomfortMedDRA releases: 2024-11 · check-in free text available
- 2022-01-05
- 2022-01-12
-
2022-01-19
Survey response — day 21, dose 3MedDRA: Headache — Feeling: FairFree text: More frequent headachesMedDRA releases: 2024-11 · check-in free text available
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2022-01-26
Survey response — day 28, dose 3MedDRA: Fatigue, Headache, Localised infection, Office visit, Pain in extremity, Self-medication — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Currently dealing with tonsil infection and headache( no relief from ibuprofen) had episodes of tiredness that would come and go all in one day. Sudden onset of metatarsal pain on both feet(no previous history of this) without reason. · Healthcare visit (other): Office visitMedDRA releases: 2024-11 · check-in free text available
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2022-01-26
Report sent to call center — day 28, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2022-01-27
- 2022-02-02
-
2022-02-09
Survey response — day 42, dose 3MedDRA: Oligomenorrhoea — Feeling: FairFree text: Women cycle has changed from regular to more spread outMedDRA releases: 2024-11 · check-in free text available
- 2022-03-30
- 2022-07-04
- 2022-12-29
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2022-12-30
Dose 4 — Pfizer-BioNTech
- 2022-12-31
- 2023-01-01
- 2023-01-02
- 2023-01-03
- 2023-01-04
-
2023-01-05
Survey response — days 1–6 daily, dose 4MedDRA: Abdominal discomfort — Feeling: Good · NauseaMedDRA releases: 2024-11
- 2023-01-08
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2023-01-15
Survey response — day 14, dose 4MedDRA: Fatigue, Hot flush — Feeling: GoodMedDRA releases: 2024-11
-
2023-01-20
Survey response — day 21, dose 4MedDRA: Migraine — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11
- 2023-01-27
- 2023-02-05
- 2023-02-10
- 2023-04-02
- 2023-06-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-04 | Moderna | |
| 2 | 2021-03-04 | Moderna | |
| 3 | 2021-12-29 | Moderna | No |
| 4 | 2022-12-30 | Pfizer-BioNTech | No |
Call center
2 call center cases
2 successful
VAERS report filed, before or during a call: 2
Free text
Release 4 — day 14, dose 1
Symptoms: Covid arm. Red & tenderness at injection site after 1 week.
Release 8 — 3 months, dose 2
Symptoms: For 2months my upper arm where vaccine was injected i have had pain with certain movements. I have some limited range of motion on that arm since my covid shot as well.
Healthcare visit (other): Visit to primary physician. Ultrasound was made, all was normal. But continue with the problem
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Arm pit and side of breast discomfort
Release 10 — day 21, dose 3
Symptoms: More frequent headaches
Release 11 — day 28, dose 3
Symptoms: Currently dealing with tonsil infection and headache( no relief from ibuprofen) had episodes of tiredness that would come and go all in one day. Sudden onset of metatarsal pain on both feet(no previous history of this) without reason.
Healthcare visit (other): Office visit
Release 11 — day 42, dose 3
Symptoms: Women cycle has changed from regular to more spread out
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 | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Hot flush | · | · | ✓ |
| SD | Immunisation reaction | ✓ | ✓ | ✓ |
| SD | Injected limb mobility decreased | ✓ | ✓ | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Localised infection | · | · | ✓ |
| SD | Migraine | · | · | ✓ |
| SD | Oligomenorrhoea | · | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SRO | Abdominal discomfort | · | · | ✓ |
| SRO | Breast discomfort | · | · | ✓ |
| SRO | Discomfort | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release