ZQE-23911-13534
5 vaccinations
34 coded responses
61 check-ins
34 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 209 / MD
- Registered
- 2021-04-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-04-15
Dose 1 — Moderna
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2021-04-26
Registered in v-safe
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2021-04-26
Survey response — day 7, dose 1MedDRA: Feeling cold, Paraesthesia, Peripheral coldness — Feeling: Fair · Site: Pain, Redness, Itching · Headache, Muscle or body aches, Fatigue or tirednessFree text: Tingling and Cold sensation in deltoid, triceps, Biceps, traps, fore arm left side. Not chills but feeling overall cold all weekMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-29
Survey response — day 14, dose 1MedDRA: Erythema, Pruritus — Feeling: FairFree text: Itching two very itchy red spots on abdomen - lasted 2-3 days. Upper back itchy maybe bumps no colorMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-06
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2021-05-13
Dose 2 — Moderna
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2021-05-13
Survey response — day 0, dose 2MedDRA: Fatigue, Feeling abnormal, Pain in extremity, Pyrexia — Feeling: Fair · Site: PainFree text: Low fever for me 1 degree up - just got shot 2 hrs ago. I do want to report overall weakness also joint pains left thumb during first shot time and continued fatigue and fuzzy thinking since first shot. .MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-14
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia, Back pain, Chills, Decreased appetite, Ear pain, Headache, Insomnia, Neck pain, Oropharyngeal pain, Tinnitus, Tremor — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: Headache backache neck ache, joint pain knees right wrist, fingers, shaking chills. Inappetence, inability to sleep, severe headache, ear pain and ringingg,MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-16
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue, Headache, Hypogeusia, Injection site pruritus, Musculoskeletal chest pain, Nasopharyngitis, Nausea, Pruritus, Pulmonary pain — Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Itchy head ,forearms, upper back. Day 1 obe othe rd sympyom lung pain kn lower rib front and back/ kidney area. Day 2 fever atill 99.5 itching back and shot site, fatigue, taste aense reduced, headache, cold, sick stomach.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-17
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness, Injection site bruising, Pruritus — Feeling: Fair · Site: Redness, Itching · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Itchy face, 4 inch ovate mark surrounding injection site, bruise at injection site, a little dizzyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-18
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · Fatigue or tirednessAdult check-in
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2021-05-19
Survey response — days 1–6 daily, dose 2MedDRA: Injection site bruising, Injection site erythema — Feeling: Good · Site: Pain · HeadacheFree text: Bruise at injection site, continue light pink mark around injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-20
Survey response — day 7, dose 2MedDRA: Disturbance in attention, Injection site bruising, Insomnia, Pruritus — Feeling: Good · Site: Pain · HeadacheFree text: Bruise at injection site. Difficultly sleeping and focusing. Itchy backMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-27
Survey response — day 14, dose 2MedDRA: Headache, Rash — Feeling: FairFree text: Rash under arm and on back. Headache.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-03
Survey response — day 21, dose 2MedDRA: Sneezing — Feeling: FairFree text: SneezingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-10
Survey response — day 28, dose 2MedDRA: Rash — Feeling: GoodFree text: Rash under armsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-17
Survey response — day 35, dose 2MedDRA: Headache — Feeling: Fair · Be unable to do your normal daily activitiesFree text: HeadachesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-24
Survey response — day 42, dose 2MedDRA: Rash pruritic — Feeling: FairFree text: Itch/ Rash under armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-08-12
- 2021-11-11
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2021-12-13
Dose 3 — Moderna
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2021-12-13
Survey response — day 0, dose 3MedDRA: Ear pain — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Ear acheMedDRA releases: 2024-11 · check-in free text available
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2021-12-14
Survey response — days 1–6 daily, dose 3MedDRA: Arthralgia, Ear pain, Hyperhidrosis, Injection site pain, Insomnia, Myalgia, Post-traumatic neck syndrome, Tinnitus, Tremor — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Ear ache, shaking, whiplash and muscle pain from neck to hamstrings, joint pain in hands and feet, earache, inabkliry to sleep all night, ringing eats, sweating, injwction aite pain from delt,triceps,to bicepaMedDRA releases: 2024-11 · check-in free text available
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2021-12-15
Survey response — days 1–6 daily, dose 3MedDRA: Hyperhidrosis, Insomnia, Rash, Tongue coated — Feeling: Fair · Site: Pain, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesFree text: Sweating, coated tongue. Inability to sleep, especially the whole girst nighf of shot. Rash on chest stomach, back.MedDRA releases: 2024-11 · check-in free text available
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2021-12-16
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness · Muscle or body aches, Nausea · Be unable to do your normal daily activitiesAdult check-in
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2021-12-17
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Redness · Fatigue or tirednessAdult check-in
- 2021-12-18
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2021-12-19
Survey response — days 1–6 daily, dose 3MedDRA: Insomnia — Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Inability to sleepMedDRA releases: 2024-11 · check-in free text available
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2021-12-20
Health check-in — day 7, dose 3Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-12-27
Survey response — day 14, dose 3MedDRA: Abdominal discomfort — Feeling: Good · Be unable to do your normal daily activitiesFree text: Upset stomacheMedDRA releases: 2024-11 · check-in free text available
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2022-01-04
Survey response — day 21, dose 3MedDRA: Gastrointestinal disorder — Feeling: Good · Be unable to do your normal daily activitiesFree text: Stomach issuesMedDRA releases: 2024-11 · check-in free text available
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2022-01-10
Survey response — day 28, dose 3MedDRA: Headache — Feeling: Fair · Be unable to do your normal daily activitiesFree text: HeadachesMedDRA releases: 2024-11 · check-in free text available
- 2022-01-17
- 2022-01-26
- 2022-03-14
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2022-04-21
Dose 4 — Moderna
- 2022-04-21
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2022-04-22
Survey response — days 1–6 daily, dose 4MedDRA: Paraesthesia — Feeling: Poor · Site: Pain, Redness, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Tingling in neck abd face near eyeMedDRA releases: 2024-11 · check-in free text available
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2022-04-23
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Redness, Itching · 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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2022-04-24
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Redness, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend schoolAdult check-in
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2022-04-25
Survey response — days 1–6 daily, dose 4MedDRA: Erythema, Immunisation reaction — Feeling: Fair · Site: Pain, Redness, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Covid arm redness covers about 4 inches x 12 inches from my neck to elbow and wraps around bicepsMedDRA releases: 2024-11 · check-in free text available
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2022-04-26
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Redness, Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2022-04-27
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
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2022-04-28
Survey response — day 7, dose 4MedDRA: Unevaluable event — Feeling: Fair · Site: Pain, Redness · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Knees shoulder backMedDRA releases: 2024-11 · check-in free text available
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2022-05-05
Survey response — day 14, dose 4MedDRA: Arthralgia, Insomnia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Pain in shoulders esp left, and knees. Inability to sleepMedDRA releases: 2024-11 · check-in free text available
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2022-05-12
Survey response — day 21, dose 4MedDRA: Pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Strong pain in left side where arm connects to bones undet trapeziusMedDRA releases: 2024-11 · check-in free text available
- 2022-05-19
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2022-05-26
Survey response — day 35, dose 4MedDRA: Bone pain, Fatigue — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Super fatigued. Still have pain in collar bone left shoulder.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-02
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2022-07-21
Survey response — 3 months, dose 4MedDRA: Arthralgia, Bone pain, Exostosis, Headache, Insomnia, Pain in extremity — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Pain left shoulder / collar bone. Bone spurs, foot and thumb joint pains. Inability to sleep, headaches.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-20
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2022-11-02
Dose 5 — Moderna
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2022-11-02
Survey response — day 0, dose 5MedDRA: Eye pruritus, Pruritus — Feeling: Fair · Site: Pain · FeverFree text: Itching right pecs left eyeMedDRA releases: 2024-11 · check-in free text available
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2022-11-03
Survey response — days 1–6 daily, dose 5MedDRA: Arthralgia, Back pain, Feeling cold, Headache, Insomnia, Musculoskeletal pain, Myalgia, Pain in extremity, Peripheral coldness, Sinus pain, Tinnitus, Unevaluable event — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Ears ringing. Severe pain in sinuses, back of head, forehead and sides of head, pain in right shoulder, wrist. Both thumbs, back at scapulae. Midback, lower back, traps, right obliques. Legs. Inability to sleep, very cold - fingers cold to the touch.MedDRA releases: 2024-11 · check-in free text available
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2022-11-03
Report sent to call center — days 1–6 daily, dose 5Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
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2022-11-04
Survey response — days 1–6 daily, dose 5MedDRA: Brain fog, Pruritus, Pyrexia, Self-medication — Feeling: Fair · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Itching sides, foggy mind, Fever measuremt is after tylenolMedDRA releases: 2024-11 · check-in free text available
- 2022-11-04
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2022-11-05
Survey response — days 1–6 daily, dose 5MedDRA: Abdominal discomfort, Brain fog — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Foggy mind, upset stomachMedDRA releases: 2024-11 · check-in free text available
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2022-11-06
Survey response — days 1–6 daily, dose 5MedDRA: Apathy, Feeling abnormal, Malaise — Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Malaise; slow to motivate , fuzzy brainMedDRA releases: 2024-11 · check-in free text available
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2022-11-07
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Fever · Headache, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activitiesAdult check-in
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2022-11-08
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2022-11-09
Health check-in — day 7, dose 5Feeling: Fair · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
- 2022-11-16
- 2022-11-23
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2022-11-30
Survey response — day 28, dose 5MedDRA: Nausea — Feeling: Fair · Be unable to do your normal daily activitiesFree text: nauseaMedDRA releases: 2024-11 · check-in free text available
- 2022-12-07
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2022-12-14
Survey response — day 42, dose 5MedDRA: Tendon pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Knee tendon painMedDRA releases: 2024-11 · check-in free text available
- 2023-02-01
- 2023-05-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-15 | Moderna | |
| 2 | 2021-05-13 | Moderna | |
| 3 | 2021-12-13 | Moderna | No |
| 4 | 2022-04-21 | Moderna | No |
| 5 | 2022-11-02 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-11-03 | Unsuccessful |
Free text
Release 8 — day 7, dose 1
Systemic reaction (other): Tingling and Cold sensation in deltoid, triceps, Biceps, traps, fore arm left side. Not chills but feeling overall cold all week
Release 8 — day 14, dose 1
Symptoms: Itching two very itchy red spots on abdomen - lasted 2-3 days. Upper back itchy maybe bumps no color
Release 8 — day 0, dose 2
Systemic reaction (other): Low fever for me 1 degree up - just got shot 2 hrs ago. I do want to report overall weakness also joint pains left thumb during first shot time and continued fatigue and fuzzy thinking since first shot. .
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Headache backache neck ache, joint pain knees right wrist, fingers, shaking chills. Inappetence, inability to sleep, severe headache, ear pain and ringingg,
Systemic reaction (other): Itchy head ,forearms, upper back. Day 1 obe othe rd sympyom lung pain kn lower rib front and back/ kidney area. Day 2 fever atill 99.5 itching back and shot site, fatigue, taste aense reduced, headache, cold, sick stomach.
Systemic reaction (other): Itchy face, 4 inch ovate mark surrounding injection site, bruise at injection site, a little dizzy
Systemic reaction (other): Bruise at injection site, continue light pink mark around injection site
Release 8 — day 7, dose 2
Systemic reaction (other): Bruise at injection site. Difficultly sleeping and focusing. Itchy back
Release 8 — day 14, dose 2
Symptoms: Rash under arm and on back. Headache.
Release 8 — day 21, dose 2
Symptoms: Sneezing
Release 9 — day 28, dose 2
Symptoms: Rash under arms
Release 9 — day 35, dose 2
Symptoms: Headaches
Release 9 — day 42, dose 2
Symptoms: Itch/ Rash under arm
Release 10 — day 0, dose 3
Systemic reaction (other): Ear ache
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Ear ache, shaking, whiplash and muscle pain from neck to hamstrings, joint pain in hands and feet, earache, inabkliry to sleep all night, ringing eats, sweating, injwction aite pain from delt,triceps,to bicepa
Systemic reaction (other): Sweating, coated tongue. Inability to sleep, especially the whole girst nighf of shot. Rash on chest stomach, back.
Systemic reaction (other): Inability to sleep
Release 10 — day 14, dose 3
Symptoms: Upset stomache
Release 10 — day 21, dose 3
Symptoms: Stomach issues
Release 10 — day 28, dose 3
Symptoms: Headaches
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Tingling in neck abd face near eye
Systemic reaction (other): Covid arm redness covers about 4 inches x 12 inches from my neck to elbow and wraps around biceps
Release 11 — day 7, dose 4
Systemic reaction (other): Knees shoulder back
Release 11 — day 14, dose 4
Symptoms: Pain in shoulders esp left, and knees. Inability to sleep
Release 11 — day 21, dose 4
Symptoms: Strong pain in left side where arm connects to bones undet trapezius
Release 11 — day 35, dose 4
Symptoms: Super fatigued. Still have pain in collar bone left shoulder.
Release 12 — 3 months, dose 4
Symptoms: Pain left shoulder / collar bone. Bone spurs, foot and thumb joint pains. Inability to sleep, headaches.
Release 12 — day 0, dose 5
Systemic reaction (other): Itching right pecs left eye
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Ears ringing. Severe pain in sinuses, back of head, forehead and sides of head, pain in right shoulder, wrist. Both thumbs, back at scapulae. Midback, lower back, traps, right obliques. Legs. Inability to sleep, very cold - fingers cold to the touch. cut off by CDC
Systemic reaction (other): Itching sides, foggy mind, Fever measuremt is after tylenol
Systemic reaction (other): Foggy mind, upset stomach
Systemic reaction (other): Malaise; slow to motivate , fuzzy brain
Release 12 — day 28, dose 5
Symptoms: nausea
Release 12 — day 42, dose 5
Symptoms: Knee tendon pain
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 | Unevaluable event | · | · | ✓ |
| SD | Abdominal discomfort | · | · | ✓ |
| SD | Arthralgia | · | · | ✓ |
| SD | Bone pain | · | · | ✓ |
| SD | Erythema | ✓ | ✓ | ✓ |
| SD | Exostosis | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Gastrointestinal disorder | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Insomnia | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rash pruritic | ✓ | ✓ | ✓ |
| SD | Sneezing | ✓ | ✓ | ✓ |
| SD | Tendon pain | · | · | ✓ |
| SRO | Abdominal discomfort | · | · | ✓ |
| SRO | Apathy | · | · | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Brain fog | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Decreased appetite | · | · | ✓ |
| SRO | Disturbance in attention | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Ear pain | · | · | ✓ |
| SRO | Erythema | · | · | ✓ |
| SRO | Eye pruritus | · | · | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Feeling cold | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Hyperhidrosis | · | · | ✓ |
| SRO | Hypogeusia | ✓ | ✓ | ✓ |
| SRO | Immunisation reaction | · | · | ✓ |
| SRO | Injection site bruising | ✓ | ✓ | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Injection site pruritus | ✓ | ✓ | ✓ |
| SRO | Insomnia | ✓ | ✓ | ✓ |
| SRO | Malaise | · | · | ✓ |
| SRO | Musculoskeletal chest pain | ✓ | ✓ | ✓ |
| SRO | Musculoskeletal pain | · | · | ✓ |
| SRO | Myalgia | · | · | ✓ |
| SRO | Nasopharyngitis | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Neck pain | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ○ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Paraesthesia | ✓ | ✓ | ✓ |
| SRO | Peripheral coldness | ✓ | ✓ | ✓ |
| SRO | Post-traumatic neck syndrome | · | · | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Pulmonary pain | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Rash | · | · | ✓ |
| SRO | Self-medication | · | · | ✓ |
| SRO | Sinus pain | · | · | ✓ |
| SRO | Tinnitus | · | · | ✓ |
| SRO | Tongue coated | · | · | ✓ |
| SRO | Tremor | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release