6Y3-73986-19430
2 vaccinations
6 coded responses
23 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 199 / DE
- Registered
- 2021-03-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-20
Dose 1 — Moderna
-
2021-03-21
Registered in v-safe
-
2021-03-21
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling · Fever · Joint pains, Fatigue or tirednessAdult check-in
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-03-27
- 2021-04-03
- 2021-04-10
-
2021-04-17
Dose 2 — Moderna
-
2021-04-17
Survey response — day 0, dose 2MedDRA: Dyspnoea — Feeling: Fair · Fatigue or tiredness · Be unable to workFree text: Short of breath for couple minutes few hours later.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-18
Survey response — days 1–6 daily, dose 2MedDRA: Aphasia, Brain fog, Burning sensation, Fatigue, Headache, Memory impairment, Mobility decreased, Muscle spasms, Pain in extremity, Peripheral swelling, Pyrexia, Self-medication — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: Brain fog. Memory issues. Mixing up words in sentences. Calling the pharmacy by one drom 1994 like I was senile. But it passed. Foot cramps into ballerina pose in bed. Last night. Wave of fatigue I could feel wash over me from head to toe. Like I was suddenly dead weight and could no longer get up. Even once I dragged myself to bed hours later. I stayed in same position. Even tho I dropped my phone I could of cared less. SeemedLike too much work to get it off the floor. Mild headache this afternoon suddenly when fever started. Arm Swelling and burning into my shoulder blade last night into today. Motrin helps. And left leg pain.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-19
Survey response — days 1–6 daily, dose 2MedDRA: Erythema, Fatigue, Headache, Insomnia, Pre-existing disease, Pyrexia, Restless legs syndrome, Self-medication — Feeling: Good · Site: Swelling · Fever · Muscle or body aches, Fatigue or tirednessFree text: Last night had trouble sleeping w headache and restless legs feelings. Headache was worse. And had fever but was too tired to get up to do anything. Went to bed at 630 pm. Also had bad brain fog. Also forgot on first day I had bright red face like a tomato all day starting about three hours in that didnt improve even with four Benadryl. I do however have mast cell disease eosinophilia and laundry list of allergies to foods dyes and environment to enviromental agents and air quality problems. But feeling better now. Just tired. And still have low grade temp. Most things are resolved.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-20
Survey response — days 1–6 daily, dose 2MedDRA: Feeling abnormal — Feeling: Good · Fatigue or tirednessFree text: Slight brain fog.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-22
- 2021-04-23
- 2021-04-24
- 2021-05-01
- 2021-05-10
- 2021-05-17
-
2021-05-22
Survey response — day 35, dose 2MedDRA: Injection site pain — Feeling: GoodFree text: Injection site became sore again that general area is tender and sore like as if someone punched me or or all the muscles hurt suddenly even tho I havent done anything. Its like the day I got first shot feeling. Out of the blue. It started agaiMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-29
- 2021-07-17
-
2022-04-19
Survey response — 12 months, dose 2MedDRA: Adverse reaction, COVID-19 — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Had covid and have some long term effects.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-19
Report sent to call center — 12 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2022-04-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-20 | Moderna | |
| 2 | 2021-04-17 | Moderna |
Call center
1 call center case
1 unsuccessful
Free text
Release 7 — day 0, dose 2
Systemic reaction (other): Short of breath for couple minutes few hours later.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Brain fog. Memory issues. Mixing up words in sentences. Calling the pharmacy by one drom 1994 like I was senile. But it passed. Foot cramps into ballerina pose in bed. Last night. Wave of fatigue I could feel wash over me from head to toe. Like I was suddenly dead weight and could no longer get up. Even once I dragged myself to bed hours later. I stayed in same position. Even tho I dropped my phone I could of cared less. SeemedLike too much work to get it off the floor. Mild headache this afternoon suddenly when fever started. Arm Swelling and burning into my shoulder blade last night into today. Motrin helps. And left leg pain.
Systemic reaction (other): Last night had trouble sleeping w headache and restless legs feelings. Headache was worse. And had fever but was too tired to get up to do anything. Went to bed at 630 pm. Also had bad brain fog. Also forgot on first day I had bright red face like a tomato all day starting about three hours in that didnt improve even with four Benadryl. I do however have mast cell disease eosinophilia and laundry list of allergies to foods dyes and environment to enviromental agents and air quality problems. But feeling better now. Just tired. And still have low grade temp. Most things are resolved.
Systemic reaction (other): Slight brain fog.
Release 8 — day 35, dose 2
Symptoms: Injection site became sore again that general area is tender and sore like as if someone punched me or or all the muscles hurt suddenly even tho I havent done anything. Its like the day I got first shot feeling. Out of the blue. It started agai
Release 11 — 12 months, dose 2
Symptoms: Had covid and have some long term effects.
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 |
|---|---|---|---|---|
| SD | Adverse reaction | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Aphasia | ✓ | ✓ | ✓ |
| SRO | Brain fog | ✓ | ✓ | ✓ |
| SRO | Burning sensation | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Insomnia | ✓ | ✓ | ✓ |
| SRO | Memory impairment | ✓ | ✓ | ✓ |
| SRO | Mobility decreased | ✓ | ✓ | ✓ |
| SRO | Muscle spasms | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Peripheral swelling | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Restless legs syndrome | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release