6RW-30729-38151
2 vaccinations
2 coded responses
17 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 062 / CT
- Registered
- 2021-01-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-04
Dose 1 — Moderna
-
2021-01-14
Registered in v-safe
-
2021-01-14
Survey response — day 7, dose 1MedDRA: Asthenia, Condition aggravated, Headache, Malaise, Mouth ulceration, Pyrexia — Feeling: Good · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Within 24 hrs of receiving the Moderna vaccine I began to feel malaise. Within 36 hrs, I began an exacerbation of mouth ulcers which I had previously controlled by not using tooth paste with SLS. The malaise and oral cavity ulcerations became increasingly worse as days passed. At one time during the week I had 6-7 ulcerations in my mouth on my gums, tongue and down into my throat. Malaise continued thru Sunday, January 10. My energy level picked up beginning Monday, Jan. 11. Today I am back to baseline on energy. As of today, January 14, 2021, the oral cavity ulcerations are resolved and no new ones are forming. I ran a low grade fever on Saturday, Jan. 9 and the remainder of the post-vaccine week I was afebrile. Beginning Jan. 7 (72 hrs after administration of the vaccine) I had a slightly irritating headache thru Sunday, Jan. 10. The headache was resolved on Monday, Jan. 11 when I awakened.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-14
Report sent to call center — day 7, dose 1Be unable to do your normal daily activities1 call case(s)
- 2021-01-18
- 2021-01-25
-
2021-02-01
Dose 2 — Moderna
- 2021-02-01
-
2021-02-02
Survey response — days 1–6 daily, dose 2MedDRA: Feeling abnormal — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesFree text: severe brain fog,MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-06
- 2021-02-07
- 2021-02-10
- 2021-02-17
- 2021-02-24
- 2021-03-03
- 2021-03-08
- 2021-03-15
- 2021-08-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-04 | Moderna | |
| 2 | 2021-02-01 | Moderna |
Call center
1 call center case
1 priority 2/3 (triaged and no follow up)
Free text
Release 2 — day 7, dose 1
Systemic reaction (other): Within 24 hrs of receiving the Moderna vaccine I began to feel malaise. Within 36 hrs, I began an exacerbation of mouth ulcers which I had previously controlled by not using tooth paste with SLS. The malaise and oral cavity ulcerations became increasingly worse as days passed. At one time during the week I had 6-7 ulcerations in my mouth on my gums, tongue and down into my throat. Malaise continued thru Sunday, January 10. My energy level picked up beginning Monday, Jan. 11. Today I am back to baseline on energy. As of today, January 14, 2021, the oral cavity ulcerations are resolved and no new ones are forming. I ran a low grade fever on Saturday, Jan. 9 and the remainder of the post-vaccine week I was afebrile. Beginning Jan. 7 (72 hrs after administration of the vaccine) I had a slightly irritating headache thru Sunday, Jan. 10. The headache was resolved on Monday, Jan. 11 when I awakened.
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): severe brain fog,
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 | Asthenia | ✓ | ✓ | ✓ |
| SRO | Condition aggravated | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Malaise | ✓ | ✓ | ✓ |
| SRO | Mouth ulceration | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release