ZW5-50560-54398
2 vaccinations
6 coded responses
9 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 920 / CA
- Registered
- 2021-02-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-01-24
Dose 1 — Moderna
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2021-02-01
Registered in v-safe
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2021-02-01
Survey response — day 7, dose 1MedDRA: Injection site pruritus, Pain in extremity, Vaccination site rash — Feeling: Fair · Site: Pain, Redness, Swelling, ItchingFree text: Now have Covid Vaccine arm? Had very little reaction initially sore arm for a couple of days . Today eight days after the vaccine I have a very red area at the vaccine site bumpy skin and very itchy in that area. I am concerned regarding the second shot as I am unable to Use the other arm because of the absence of the multiple lymph nodes.Symptoms very similar to the article in psychology today as described by Dr. (b)(6). I would very much like to know how people react to the second shot who have had this experience. Thank you will keep you postedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-12
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2021-02-23
Survey response — day 28, dose 1MedDRA: Musculoskeletal stiffness, Neck pain — Feeling: GoodFree text: Very painful and stiff neck mainly on Rt side for the past 5 days but I do not think it is related to the vaccine It is still sore but improving.More likely due to a lot of sitting or wrong posture in bed.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-03
Dose 2 — Moderna
- 2021-03-12
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2021-03-17
Survey response — day 14, dose 2MedDRA: Abdominal discomfort, Chills, Fatigue — Feeling: GoodFree text: Chills on appx day 10 and tired and minor gut issuesIt all passed. Not severe .MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-01
Survey response — day 28, dose 2MedDRA: Diverticulitis, Intervertebral disc protrusion, Muscle spasms, Pre-existing disease — Feeling: Poor · Be unable to work, Be unable to do your normal daily activitiesFree text: Lower back spasm (herniated disc history)Diverticulitis attack (have history)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-16
Survey response — day 42, dose 2MedDRA: Aphasia, Feeling abnormal — Feeling: GoodFree text: I seem to have some difficulty recalling names or words that I usually know.. Not sure if this is temporary so called brain fog or not. I have noticed this for several weeks.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-04
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2021-09-04
Survey response — 6 months, dose 2MedDRA: Memory impairment — Feeling: GoodFree text: Some forgetfulnessMedDRA releases: 2021-09,2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-24 | Moderna | |
| 2 | 2021-03-03 | Moderna |
Free text
Release 3 — day 7, dose 1
Systemic reaction (other): Now have Covid Vaccine arm? Had very little reaction initially sore arm for a couple of days . Today eight days after the vaccine I have a very red area at the vaccine site bumpy skin and very itchy in that area. I am concerned regarding the second shot as I am unable to Use the other arm because of the absence of the multiple lymph nodes.Symptoms very similar to the article in psychology today as described by Dr. (b)(6). I would very much like to know how people react to the second shot who have had this experience. Thank you will keep you posted
redacted (b)(6)
Release 4 — day 28, dose 1
Symptoms: Very painful and stiff neck mainly on Rt side for the past 5 days but I do not think it is related to the vaccine It is still sore but improving.More likely due to a lot of sitting or wrong posture in bed.
Release 5 — day 14, dose 2
Symptoms: Chills on appx day 10 and tired and minor gut issuesIt all passed. Not severe .
Release 6 — day 28, dose 2
Symptoms: Lower back spasm (herniated disc history)Diverticulitis attack (have history)
Release 7 — day 42, dose 2
Symptoms: I seem to have some difficulty recalling names or words that I usually know.. Not sure if this is temporary so called brain fog or not. I have noticed this for several weeks.
Release 9 — 6 months, dose 2
Symptoms: Some forgetfulness
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 | Aphasia | ✓ | ✓ | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Diverticulitis | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Feeling abnormal | ✓ | ✓ | ✓ |
| SD | Intervertebral disc protrusion | ✓ | ✓ | ✓ |
| SD | Memory impairment | ✓ | · | ✓ |
| SD | Muscle spasms | ✓ | ✓ | ✓ |
| SD | Musculoskeletal stiffness | ✓ | ✓ | ✓ |
| SD | Neck pain | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Injection site pruritus | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Vaccination site rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release