6KK-22796-27459
5 vaccinations
5 coded responses
37 check-ins
5 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 201 / VA
- Registered
- 2021-02-03
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-03
Registered in v-safe
-
2021-02-03
Dose 1 — Moderna
- 2021-02-03
-
2021-02-04
Survey response — days 1–6 daily, dose 1MedDRA: Pain in extremity — Feeling: Good · Site: Pain · Joint painsFree text: I have a soreness in my upper arm and aching through the upper right arm and upper right back area. It is a constant ache. Last night was bad, better today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-05
Survey response — days 1–6 daily, dose 1MedDRA: Insomnia, Pain, Pain in extremity, Self-medication — Feeling: Good · Joint painsFree text: I had very moderate aching and pain and stiffness in my upper arm near the top of the humerus/ next to the clavicle for two straight days and could not sleep for the extensive aching. Today, I took one Advil and have no pain. This is my third day from the vaccination date of 2/3/2021. I did not take any pain meds till this one Advil today. I am back to normal activities.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-06
- 2021-02-07
- 2021-02-09
- 2021-02-10
- 2021-02-17
- 2021-02-24
-
2021-03-03
Dose 2 — Moderna
-
2021-03-05
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue, Pain — Feeling: Good · Muscle or body aches, Fatigue or tirednessFree text: After the first 12 hours, I experienced achy feeling and fatigue, no pain or soreness this time.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-06
- 2021-03-07
- 2021-03-08
-
2021-03-09
Survey response — days 1–6 daily, dose 2MedDRA: Adverse reaction — Feeling: GoodFree text: VAMS has not put my 2nd dose in system. 3-3-2021 ModernaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-03-31
- 2021-04-07
- 2021-04-14
- 2021-06-02
- 2021-09-01
-
2021-10-20
Dose 3 — Moderna
-
2021-10-27
Survey response — day 7, dose 3MedDRA: Body temperature increased, Chills, Erythema, Swelling — Feeling: Good · Site: ItchingFree text: I had a large 3-5 inch red swollen area for 4 days After the shot, chills/ 99.7 fever on second day, chills for 1 day.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-03
- 2021-11-12
- 2021-11-17
- 2021-11-24
- 2021-12-01
- 2022-01-19
-
2022-03-31
Dose 4 — Moderna
- 2022-04-18
- 2022-04-21
- 2022-04-28
- 2022-05-05
- 2022-05-12
- 2022-06-30
-
2022-09-07
Dose 5 — ModernaCo-administered: Flu
- 2022-09-29
- 2023-03-31
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-03 | Moderna | |
| 2 | 2021-03-03 | Moderna | |
| 3 | 2021-10-20 | Moderna | No |
| 4 | 2022-03-31 | Moderna | No |
| 5 | 2022-09-07 | Moderna | Flu |
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): I have a soreness in my upper arm and aching through the upper right arm and upper right back area. It is a constant ache. Last night was bad, better today.
Systemic reaction (other): I had very moderate aching and pain and stiffness in my upper arm near the top of the humerus/ next to the clavicle for two straight days and could not sleep for the extensive aching. Today, I took one Advil and have no pain. This is my third day from the vaccination date of 2/3/2021. I did not take any pain meds till this one Advil today. I am back to normal activities.
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): After the first 12 hours, I experienced achy feeling and fatigue, no pain or soreness this time.
Systemic reaction (other): VAMS has not put my 2nd dose in system. 3-3-2021 Moderna
Release 10 — day 7, dose 3
Systemic reaction (other): I had a large 3-5 inch red swollen area for 4 days After the shot, chills/ 99.7 fever on second day, chills for 1 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 |
|---|---|---|---|---|
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Body temperature increased | · | · | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Erythema | · | · | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Insomnia | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Swelling | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release