6DZ-42203-40160
1 vaccination
10 coded responses
11 check-ins
10 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 346 / FL
- Registered
- 2021-03-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-12
Dose 1 — Moderna
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2021-03-13
Registered in v-safe
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2021-03-13
Survey response — days 1–6 daily, dose 1MedDRA: Pain, Pre-existing disease — Feeling: GoodFree text: I have fibromyalgia so always some painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-14
Survey response — days 1–6 daily, dose 1MedDRA: Arthritis, Fibromyalgia — Feeling: Fair · Joint pains, Muscle or body achesFree text: Arthritis and fibromyalgiaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-15
Survey response — days 1–6 daily, dose 1MedDRA: Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body achesFree text: Arthritis and fibromyalgiaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-17
Survey response — days 1–6 daily, dose 1MedDRA: Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body achesFree text: Arthritis and fibromyalgiaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-18
Survey response — days 1–6 daily, dose 1MedDRA: Arthritis, Fibromyalgia — Feeling: Fair · Joint pains, Muscle or body achesFree text: Arthritis and fibromyalgiaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-19
Survey response — day 7, dose 1MedDRA: Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body achesFree text: Arthritis and fibromyalgiaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-26
Survey response — day 14, dose 1MedDRA: Immunisation reaction — Feeling: FairFree text: Covid armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-02
Survey response — day 21, dose 1MedDRA: Hyperhidrosis, Pruritus, Pyrexia, Rash macular — Feeling: FairFree text: Red itchy blotches on my stomach and all areas that I sweat and skin touches skin and a low fever it started last nightMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-09
Survey response — day 28, dose 1MedDRA: Rash, Unevaluable event — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: All over body rash and it was from my first shot so I was informed not to get the second one · Healthcare visit (other): Given medsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-09
Report sent to call center — day 28, dose 1Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-09-10
Survey response — 6 months, dose 1MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: I had a severe break out of my Steven Johnson syndrome from getting the first vaccine Madonna I was not able to get the second shot so I don't feel like I am totally safe but I stay isolated most of the time and wear a mask when I do have to go outMedDRA releases: 2024-11 · check-in free text available
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2021-09-10
Report sent to call center — 6 months, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-13
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2021-09-13
Call successfulDoes not wish to fill out VAERS report
- 2022-03-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-12 | Moderna |
Call center
2 call center cases
2 successful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): I have fibromyalgia so always some pain
Systemic reaction (other): Arthritis and fibromyalgia
Systemic reaction (other): Arthritis and fibromyalgia
Systemic reaction (other): Arthritis and fibromyalgia
Systemic reaction (other): Arthritis and fibromyalgia
Release 5 — day 7, dose 1
Systemic reaction (other): Arthritis and fibromyalgia
Release 6 — day 14, dose 1
Symptoms: Covid arm
Release 6 — day 21, dose 1
Symptoms: Red itchy blotches on my stomach and all areas that I sweat and skin touches skin and a low fever it started last night
Release 7 — day 28, dose 1
Symptoms: All over body rash and it was from my first shot so I was informed not to get the second one
Healthcare visit (other): Given meds
Release 9 — 6 months, dose 1
Symptoms: I had a severe break out of my Steven Johnson syndrome from getting the first vaccine Madonna I was not able to get the second shot so I don't feel like I am totally safe but I stay isolated most of the time and wear a mask when I do have to go out cut off by CDC
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 | Condition aggravated | · | · | ✓ |
| SD | Hyperhidrosis | ✓ | ✓ | ✓ |
| SD | Immunisation reaction | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rash macular | ✓ | ✓ | ✓ |
| SRO | Arthritis | ✓ | ✓ | ✓ |
| SRO | Fibromyalgia | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release