JH9-10898-91778
2 vaccinations
6 coded responses
22 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 948 / CA
- Registered
- 2021-05-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-05-05
Dose 1 — Moderna
-
2021-05-06
Registered in v-safe
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2021-05-06
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: Fair · Site: Pain, Redness · Rash, not including the immediate area around the injection siteFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-08
Survey response — days 1–6 daily, dose 1MedDRA: Pruritus, Rash, Rash erythematous — Feeling: Fair · Site: Redness, ItchingFree text: Full arm itches and red guzbumpsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-09
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Redness, Itching · Rash, not including the immediate area around the injection siteAdult check-in
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2021-05-10
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Redness, Itching · Fatigue or tiredness, Rash, not including the immediate area around the injection siteAdult check-in
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2021-05-11
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Redness, Itching · Headache, Rash, not including the immediate area around the injection siteAdult check-in
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2021-05-12
Health check-in — day 7, dose 1Feeling: Fair · Site: Redness, Itching · Fatigue or tirednessAdult check-in
- 2021-05-19
- 2021-05-26
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2021-06-02
Dose 2 — Moderna
- 2021-06-02
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2021-06-03
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-06-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-06-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Swelling · Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
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2021-06-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Swelling · Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
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2021-06-08
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Swelling · Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
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2021-06-09
Health check-in — day 7, dose 2Feeling: Fair · Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
- 2021-06-16
- 2021-06-23
- 2021-06-30
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2021-07-07
Survey response — day 35, dose 2MedDRA: Abortion spontaneous — Feeling: Poor · Be unable to do your normal daily activitiesFree text: MiscarriageMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-14
Survey response — day 42, dose 2MedDRA: Abortion spontaneous, Arthralgia — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: My joints ache and I miscarriageMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-14
Report sent to call center — day 42, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-21
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2021-09-01
Survey response — 3 months, dose 2MedDRA: Arthralgia, Peripheral swelling — Feeling: Poor · Be unable to do your normal daily activitiesFree text: All of my joints hurt and my feet get constantly swollenMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-12-01
Survey response — 6 months, dose 2MedDRA: Peripheral swelling — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Swollen legs constantlyMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-05-05 | Moderna | |
| 2 | 2021-06-02 | Moderna |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-07-14 | Unsuccessful |
Free text
Release 8 — days 1–6 daily, dose 1
Systemic reaction (other): No
Systemic reaction (other): Full arm itches and red guzbumps
Release 9 — day 35, dose 2
Symptoms: Miscarriage
Release 9 — day 42, dose 2
Symptoms: My joints ache and I miscarriage
Release 9 — 3 months, dose 2
Symptoms: All of my joints hurt and my feet get constantly swollen
Release 10 — 6 months, dose 2
Symptoms: Swollen legs constantly
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 | Abortion spontaneous | ✓ | ✓ | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Peripheral swelling | ✓ | · | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Rash erythematous | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release