6WL-12975-45854
2 vaccinations
7 coded responses
17 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 851 / AZ
- Registered
- 2021-03-05
- Relationship
- Self
- Race
- White
- Ethnicity
- N/A
Timeline
-
2021-03-05
Registered in v-safe
-
2021-03-05
Dose 1 — Moderna
- 2021-03-05
-
2021-03-06
Survey response — days 1–6 daily, dose 1MedDRA: Insomnia, Sleep disorder — Feeling: Good · Site: Pain, Swelling · Muscle or body achesFree text: Cant sleep since vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-07
Survey response — days 1–6 daily, dose 1MedDRA: Cough — Feeling: GoodFree text: Coughing more but attribute it to allergiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-08
- 2021-03-09
-
2021-03-11
Survey response — days 1–6 daily, dose 1MedDRA: Back pain, Office visit — Feeling: Fair · Joint pains, Muscle or body aches · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): Im not sure that the back pain Im experiencing the last 3 days has anything at all to do with Covid. I have back problems but they have really gotten bad in the last 3 days. · Healthcare visit (other): ChiropractorMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-11
Report sent to call center — days 1–6 daily, 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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2021-03-12
Survey response — day 7, dose 1MedDRA: Unevaluable event — Feeling: Poor · Joint pains · Be unable to do your normal daily activitiesFree text: I dont think my problems are caused by vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-19
-
2021-03-28
Survey response — day 21, dose 1MedDRA: Rash — Feeling: GoodFree text: Rash on sides of face and neck. Not particularly itchy. This is the 2nd time nowMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-03
-
2021-04-08
Dose 2 — Moderna
-
2021-04-09
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-11
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2021-04-12
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue, Nasopharyngitis, Pain, Respiratory tract congestion, Somnolence — Feeling: Fair · Fever · Be unable to do your normal daily activitiesFree text: Felt like I had a cold coming on, stuffed up. Think allergies more than shot reaction. Extremely tired and achy slept most of afternoon.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-13
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue — Feeling: Good · Fatigue or tirednessFree text: The fatigue from yesterday was less this morning and getting betterMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-15
- 2021-07-08
- 2021-10-07
- 2022-03-02
-
2022-03-02
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-05 | Moderna | |
| 2 | 2021-04-08 | Moderna |
Call center
1 call center case
1 successful
1 wait over 3 months for a first call
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Cant sleep since vaccine
Systemic reaction (other): Coughing more but attribute it to allergies
Systemic reaction (other): Im not sure that the back pain Im experiencing the last 3 days has anything at all to do with Covid. I have back problems but they have really gotten bad in the last 3 days.
Healthcare visit (other): Chiropractor
Release 5 — day 7, dose 1
Systemic reaction (other): I dont think my problems are caused by vaccine
Release 6 — day 21, dose 1
Symptoms: Rash on sides of face and neck. Not particularly itchy. This is the 2nd time now
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Felt like I had a cold coming on, stuffed up. Think allergies more than shot reaction. Extremely tired and achy slept most of afternoon.
Systemic reaction (other): The fatigue from yesterday was less this morning and getting better
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 | Rash | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Insomnia | · | · | ✓ |
| SRO | Nasopharyngitis | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SRO | Sleep disorder | ✓ | ✓ | ○ |
| SRO | Somnolence | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release