6X9-40438-05773
5 vaccinations
7 coded responses
40 check-ins
6 free-text entries
2 call cases
- Sex
- Male
- Age at first dose
- 61-65
- ZIP prefix
- 902 / CA
- Registered
- 2021-02-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-19
Registered in v-safe
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2021-02-19
Dose 1 — Moderna
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2021-02-19
Health check-in — day 0, dose 1Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-02-20
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Headache, Joint painsAdult check-in
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-02-25
- 2021-02-27
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2021-03-05
Survey response — day 14, dose 1MedDRA: Contusion, Pruritus, Urticaria — Feeling: GoodFree text: Developed a welt in my vaccination arm about 10 days after after receiving the dose, and then severe bruising appeared in that spot. It also itched for a few days.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-12
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2021-03-19
Dose 2 — Moderna
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2021-03-19
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-03-20
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-03-21
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-03-22
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-23
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2021-03-24
Survey response — days 1–6 daily, dose 2MedDRA: Toothache — Feeling: Good · Site: Pain, RednessFree text: My teeth have been hurting today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-25
- 2021-03-26
- 2021-04-02
- 2021-04-09
- 2021-04-16
- 2021-04-23
- 2021-04-30
- 2021-06-20
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2021-09-18
Survey response — 6 months, dose 2MedDRA: Arthritis, Gait disturbance, Inflammation, Pain — Feeling: Good · Be unable to do your normal daily activitiesFree text: One day I experienced what seemed like almost total body inflammation which seemed to come out of the blue, mainly affecting my joints, most prominently my lower back/hipsI could barely walk. The next day I had some residual pain, but it had endedMedDRA releases: 2024-11 · check-in free text available
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2021-11-05
Dose 3 — Moderna
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2022-03-19
Survey response — 12 months, dose 2MedDRA: Injection site pain, Pain — Feeling: GoodFree text: Upper arm soreness of the arm in which I received my Covid vaccinations, sometimes intense pain, usually just mild but exacerbated when I reach for something.MedDRA releases: 2024-11 · check-in free text available
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2022-05-06
Dose 4 — Moderna
- 2022-05-06
- 2022-05-15
- 2022-05-21
- 2022-05-27
- 2022-06-03
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2022-06-10
Survey response — day 35, dose 4MedDRA: Fatigue, Pain, Pain in extremity — Feeling: Good · Be unable to do your normal daily activitiesFree text: 2 days ago I experienced overwhelming exhaustion and overall body soreness, though mostly in my legs. Felt like I was coming down with something, but had no fever. Much better the next day, completely recovered today.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-17
- 2022-08-06
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2022-09-09
Dose 5 — ModernaCo-administered: Flu
- 2022-10-04
- 2022-10-07
- 2022-10-15
- 2022-10-23
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2022-12-09
Survey response — 3 months, dose 5MedDRA: Acupuncture, Arthralgia, Office visit, Pain in extremity, Sciatica — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Excruciatingly painful sciatica down the right hip and leg. · Healthcare visit (other): Chiropractor and acupuncture.MedDRA releases: 2024-11 · check-in free text available
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2022-12-09
Report sent to call center — 3 months, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2022-12-13
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2023-03-10
Survey response — 6 months, dose 5MedDRA: COVID-19, Nerve compression, Sciatica, Transient ischaemic attack — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationMedDRA releases: 2024-11
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2023-03-10
Report sent to call center — 6 months, dose 5Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2023-03-13
- 2023-03-13
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2023-03-17
Call successfulCompleted over the phone
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2023-03-17
Call successfulCompleted over the phone
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-19 | Moderna | |
| 2 | 2021-03-19 | Moderna | |
| 3 | 2021-11-05 | Moderna | No |
| 4 | 2022-05-06 | Moderna | No |
| 5 | 2022-09-09 | Moderna | Flu |
Call center
2 call center cases
2 successful
VAERS report filed, before or during a call: 2
Free text
Release 5 — day 14, dose 1
Symptoms: Developed a welt in my vaccination arm about 10 days after after receiving the dose, and then severe bruising appeared in that spot. It also itched for a few days.
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): My teeth have been hurting today.
Release 9 — 6 months, dose 2
Symptoms: One day I experienced what seemed like almost total body inflammation which seemed to come out of the blue, mainly affecting my joints, most prominently my lower back/hipsI could barely walk. The next day I had some residual pain, but it had ended
Release 11 — 12 months, dose 2
Symptoms: Upper arm soreness of the arm in which I received my Covid vaccinations, sometimes intense pain, usually just mild but exacerbated when I reach for something.
Release 12 — day 35, dose 4
Symptoms: 2 days ago I experienced overwhelming exhaustion and overall body soreness, though mostly in my legs. Felt like I was coming down with something, but had no fever. Much better the next day, completely recovered today.
Release 12 — 3 months, dose 5
Symptoms: Excruciatingly painful sciatica down the right hip and leg.
Healthcare visit (other): Chiropractor and acupuncture.
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 | Acupuncture | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| SD | Arthralgia | · | · | ✓ |
| SD | Arthritis | · | · | ✓ |
| SD | Contusion | ✓ | ✓ | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Gait disturbance | · | · | ✓ |
| SD | Inflammation | · | · | ✓ |
| SD | Injection site pain | · | · | ✓ |
| SD | Nerve compression | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Sciatica | · | · | ✓ |
| SD | Transient ischaemic attack | · | · | ✓ |
| SD | Urticaria | ✓ | ✓ | ✓ |
| SRO | Toothache | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release