Z82-17050-32634
5 vaccinations
9 coded responses
54 check-ins
8 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 218 / MD
- Registered
- 2021-02-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-02-18
Registered in v-safe
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2021-02-18
Dose 1 — Moderna
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2021-02-18
Survey response — day 0, dose 1MedDRA: Muscle spasms — Feeling: Fair · Site: Pain · Fever · Fatigue or tirednessFree text: Vac arm spasming around bicep areaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-19
Survey response — days 1–6 daily, dose 1MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain, Redness, Swelling · HeadacheFree text: Foggy headedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-20
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Fatigue or tirednessAdult check-in
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2021-02-21
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling · HeadacheAdult check-in
- 2021-02-22
- 2021-02-23
- 2021-02-24
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2021-02-25
Health check-in — day 7, dose 1Feeling: Fair · Site: Pain · Joint pains, Muscle or body achesAdult check-in
- 2021-03-04
- 2021-03-11
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2021-03-15
Dose 2 — Moderna
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2021-03-15
Health check-in — day 0, dose 2Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-03-16
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-03-17
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Itching · Headache, Joint painsAdult check-in
- 2021-03-18
- 2021-03-19
- 2021-03-20
- 2021-03-21
- 2021-03-22
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2021-03-29
Survey response — day 14, dose 2MedDRA: Arthralgia, Injection site induration, Injection site pain, Injection site swelling, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Left arm where I rcvd both vaccination had been pain free, till two days ago, I woke up and my arm hurt (7) from just below injection site to about 1/2 way from shoulder joint to my collar bone. The area at or near my vaccine was swollen and hard.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-05
- 2021-04-12
- 2021-04-19
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2021-04-26
Survey response — day 42, dose 2MedDRA: Injection site induration, Injection site nodule, Injection site reaction — Feeling: GoodFree text: Have a hard place or a knot at the injection site. Doesnt hurt, noticed when I showered. Just odd!MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-14
Survey response — 3 months, dose 2MedDRA: Injection site nodule, Injection site pain, Muscular weakness — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Ive developed a knot at the injection site, and is a 3-4 on pain scale, but also causes weakness in my left arm (at or near the injection site and the muscle around it) Its tolerable but bothersome.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-09-13
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2021-10-25
Dose 3 — Moderna
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2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Swelling, Itching · Joint painsAdult check-in
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2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint painsAdult check-in
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2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Itching · Headache, Joint painsAdult check-in
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2021-10-31
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Joint painsAdult check-in
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
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2021-12-06
Survey response — day 42, dose 3MedDRA: Hyposmia — Feeling: GoodFree text: Partial loss of smell. Strong ofors such as bleach, enamel paint and gasoline i can smell but can't smell lesser odors, still have taste, and no ther symtoms.MedDRA releases: 2024-11 · check-in free text available
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2022-01-24
Survey response — 3 months, dose 3MedDRA: Chills, Malaise, Pain, Pyrexia, SARS-CoV-2 test negative — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Sudden onset of chills, fever, body aches! Been two days of above, dif covid-19 test, negative. But still feeling crappy!MedDRA releases: 2024-11 · check-in free text available
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2022-04-13
Dose 4 — Moderna
- 2022-04-18
- 2022-04-19
- 2022-04-20
- 2022-04-27
- 2022-05-04
- 2022-05-11
- 2022-05-18
- 2022-05-25
- 2022-07-13
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2022-09-28
Dose 5 — Moderna
- 2022-10-04
- 2022-10-05
- 2022-10-12
- 2022-10-19
- 2022-10-26
- 2022-11-02
- 2022-11-09
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2022-12-28
Survey response — 3 months, dose 5MedDRA: Diarrhoea, Headache, Pain, Rhinorrhoea — Feeling: PoorFree text: Headache, runny nose, body ache, diarrheaMedDRA releases: 2024-11 · check-in free text available
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2023-03-29
Survey response — 6 months, dose 5MedDRA: Abdominal discomfort, Decreased appetite, Headache, Pain, Pyrexia, SARS-CoV-2 test positive — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationMedDRA releases: 2024-11
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2023-03-29
Report sent to call center — 6 months, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2023-03-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-18 | Moderna | |
| 2 | 2021-03-15 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-04-13 | Moderna | No |
| 5 | 2022-09-28 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2023-03-29 | Unsuccessful |
Free text
Release 4 — day 0, dose 1
Systemic reaction (other): Vac arm spasming around bicep area
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Foggy headed
Release 6 — day 14, dose 2
Symptoms: Left arm where I rcvd both vaccination had been pain free, till two days ago, I woke up and my arm hurt (7) from just below injection site to about 1/2 way from shoulder joint to my collar bone. The area at or near my vaccine was swollen and hard.
Release 8 — day 42, dose 2
Symptoms: Have a hard place or a knot at the injection site. Doesnt hurt, noticed when I showered. Just odd!
Release 9 — 3 months, dose 2
Symptoms: Ive developed a knot at the injection site, and is a 3-4 on pain scale, but also causes weakness in my left arm (at or near the injection site and the muscle around it) Its tolerable but bothersome.
Release 10 — day 42, dose 3
Symptoms: Partial loss of smell. Strong ofors such as bleach, enamel paint and gasoline i can smell but can't smell lesser odors, still have taste, and no ther symtoms.
Release 11 — 3 months, dose 3
Symptoms: Sudden onset of chills, fever, body aches! Been two days of above, dif covid-19 test, negative. But still feeling crappy!
Release 12 — 3 months, dose 5
Symptoms: Headache, runny nose, body ache, diarrhea
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 | Abdominal discomfort | · | · | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Decreased appetite | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Hyposmia | · | · | ✓ |
| SD | Injection site induration | ✓ | ✓ | ✓ |
| SD | Injection site nodule | ✓ | ✓ | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Injection site reaction | ✓ | ✓ | ○ |
| SD | Injection site swelling | ✓ | ✓ | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Muscular weakness | ✓ | ✓ | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Muscle spasms | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release