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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

  1. 2021-01-24
    Dose 1 — Moderna
  2. 2021-02-01
    Registered in v-safe
  3. 2021-02-01
    Survey response — day 7, dose 1
    MedDRA: Injection site pruritus, Pain in extremity, Vaccination site rash — Feeling: Fair · Site: Pain, Redness, Swelling, Itching
    Free 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 posted
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-02-12
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  5. 2021-02-23
    Survey response — day 28, dose 1
    MedDRA: Musculoskeletal stiffness, Neck pain — Feeling: Good
    Free 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
  6. 2021-03-03
    Dose 2 — Moderna
  7. 2021-03-12
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  8. 2021-03-17
    Survey response — day 14, dose 2
    MedDRA: Abdominal discomfort, Chills, Fatigue — Feeling: Good
    Free 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
  9. 2021-04-01
    Survey response — day 28, dose 2
    MedDRA: Diverticulitis, Intervertebral disc protrusion, Muscle spasms, Pre-existing disease — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities
    Free text: Lower back spasm (herniated disc history)Diverticulitis attack (have history)
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-04-16
    Survey response — day 42, dose 2
    MedDRA: Aphasia, Feeling abnormal — Feeling: Good
    Free 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
  11. 2021-06-04
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-09-04
    Survey response — 6 months, dose 2
    MedDRA: Memory impairment — Feeling: Good
    Free text: Some forgetfulness
    MedDRA releases: 2021-09,2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-01-24Moderna
22021-03-03Moderna

Free text

Release 3 — day 7, dose 1

2021-02-01

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

2021-02-23

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

2021-03-17

Symptoms: Chills on appx day 10 and tired and minor gut issuesIt all passed. Not severe .

Release 6 — day 28, dose 2

2021-04-01

Symptoms: Lower back spasm (herniated disc history)Diverticulitis attack (have history)

Release 7 — day 42, dose 2

2021-04-16

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

2021-09-04

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

FieldPreferred term2021-092023-042024-11
SDAbdominal discomfort ✓ ✓ ✓
SDAphasia ✓ ✓ ✓
SDChills ✓ ✓ ✓
SDDiverticulitis ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDFeeling abnormal ✓ ✓ ✓
SDIntervertebral disc protrusion ✓ ✓ ✓
SDMemory impairment ✓ · ✓
SDMuscle spasms ✓ ✓ ✓
SDMusculoskeletal stiffness ✓ ✓ ✓
SDNeck pain ✓ ✓ ✓
SDPre-existing disease ✓ ✓ ✓
SROInjection site pruritus ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROVaccination site rash ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release