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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

  1. 2021-03-12
    Dose 1 — Moderna
  2. 2021-03-13
    Registered in v-safe
  3. 2021-03-13
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pain, Pre-existing disease — Feeling: Good
    Free text: I have fibromyalgia so always some pain
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-14
    Survey response — days 1–6 daily, dose 1
    MedDRA: Arthritis, Fibromyalgia — Feeling: Fair · Joint pains, Muscle or body aches
    Free text: Arthritis and fibromyalgia
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-15
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body aches
    Free text: Arthritis and fibromyalgia
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-03-17
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body aches
    Free text: Arthritis and fibromyalgia
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-03-18
    Survey response — days 1–6 daily, dose 1
    MedDRA: Arthritis, Fibromyalgia — Feeling: Fair · Joint pains, Muscle or body aches
    Free text: Arthritis and fibromyalgia
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-03-19
    Survey response — day 7, dose 1
    MedDRA: Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body aches
    Free text: Arthritis and fibromyalgia
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-03-26
    Survey response — day 14, dose 1
    MedDRA: Immunisation reaction — Feeling: Fair
    Free text: Covid arm
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-04-02
    Survey response — day 21, dose 1
    MedDRA: Hyperhidrosis, Pruritus, Pyrexia, Rash macular — Feeling: Fair
    Free text: Red itchy blotches on my stomach and all areas that I sweat and skin touches skin and a low fever it started last night
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-04-09
    Survey response — day 28, dose 1
    MedDRA: 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 consultation
    Free 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 meds
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-04-09
    Report sent to call center — day 28, dose 1
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  13. 2021-09-10
    Survey response — 6 months, dose 1
    MedDRA: 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 consultation
    Free 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 out
    MedDRA releases: 2024-11 · check-in free text available
  14. 2021-09-10
    Report sent to call center — 6 months, dose 1
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  15. 2021-09-13
  16. 2021-09-13
    Call successful
    Does not wish to fill out VAERS report
  17. 2022-03-12
    Health check-in — 12 months, dose 1
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-12Moderna

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-13

Systemic reaction (other): I have fibromyalgia so always some pain

2021-03-14

Systemic reaction (other): Arthritis and fibromyalgia

2021-03-15

Systemic reaction (other): Arthritis and fibromyalgia

2021-03-17

Systemic reaction (other): Arthritis and fibromyalgia

2021-03-18

Systemic reaction (other): Arthritis and fibromyalgia

Release 5 — day 7, dose 1

2021-03-19

Systemic reaction (other): Arthritis and fibromyalgia

Release 6 — day 14, dose 1

2021-03-26

Symptoms: Covid arm

Release 6 — day 21, dose 1

2021-04-02

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

2021-04-09

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

2021-09-10

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

FieldPreferred term2021-092023-042024-11
HCVOUnevaluable event ✓ ✓ ✓
SDCondition aggravated · · ✓
SDHyperhidrosis ✓ ✓ ✓
SDImmunisation reaction ✓ ✓ ✓
SDPre-existing disease · · ✓
SDPruritus ✓ ✓ ✓
SDPyrexia ✓ ✓ ✓
SDRash ✓ ✓ ✓
SDRash macular ✓ ✓ ✓
SROArthritis ✓ ✓ ✓
SROFibromyalgia ✓ ✓ ✓
SROPain ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release