ZWW-32315-22627
2 vaccinations
6 coded responses
21 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 300 / GA
- Registered
- 2021-01-16
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-16
Registered in v-safe
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2021-01-16
Dose 1 — Moderna
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2021-01-17
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-01-18
- 2021-01-21
- 2021-01-23
- 2021-01-30
- 2021-02-06
-
2021-02-13
Dose 2 — Moderna
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2021-02-13
Survey response — day 0, dose 2MedDRA: Injection site pain, Pain in extremity — Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to do your normal daily activitiesFree text: Injection site pain, left arm painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-14
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-02-15
Survey response — days 1–6 daily, dose 2MedDRA: Medical counselling, Shoulder injury related to vaccine administration — Feeling: Fair · Site: Pain · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Systemic reaction (other): I have possibly have shoulder related to vaccine administration (SIRVA). My vaccine was placed way too high and I probably have shoulder bursitis. · Healthcare visit (other): My brother is an orthopedist and consulted with himMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-15
Report sent to call center — days 1–6 daily, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-02-17
Survey response — days 1–6 daily, dose 2MedDRA: Bursitis — Feeling: Fair · Site: Pain · Be unable to do your normal daily activitiesFree text: Bursitis secondary to shoulder injury related to vaccination administrationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-18
Survey response — days 1–6 daily, dose 2MedDRA: Bursitis, Shoulder injury related to vaccine administration — Feeling: Fair · Site: Pain · Be unable to do your normal daily activitiesFree text: Shoulder injury related to vaccine administration-bursitisMedDRA 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 2MedDRA: Limb injury, Poor quality product administered — Feeling: Fair · Site: PainFree text: Shoulder injury related to vaccine administrationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-22
Survey response — day 7, dose 2MedDRA: Shoulder injury related to vaccine administration — Feeling: Fair · Site: PainFree text: Shoulder injury related to vaccine administrationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-27
- 2021-03-06
- 2021-03-13
- 2021-03-20
- 2021-03-27
- 2021-05-15
- 2021-08-02
- 2021-08-14
- 2022-02-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-16 | Moderna | |
| 2 | 2021-02-13 | Moderna |
Call center
1 call center case
1 unsuccessful
1 wait over 3 months for a first call
Free text
Release 4 — day 0, dose 2
Systemic reaction (other): Injection site pain, left arm pain
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): I have possibly have shoulder related to vaccine administration (SIRVA). My vaccine was placed way too high and I probably have shoulder bursitis.
Healthcare visit (other): My brother is an orthopedist and consulted with him
Systemic reaction (other): Bursitis secondary to shoulder injury related to vaccination administration
Systemic reaction (other): Shoulder injury related to vaccine administration-bursitis
Systemic reaction (other): Shoulder injury related to vaccine administration
Release 4 — day 7, dose 2
Systemic reaction (other): Shoulder injury related to vaccine administration
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 | Medical counselling | ✓ | ✓ | ✓ |
| SRO | Bursitis | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Limb injury | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Poor quality product administered | ○ | ✓ | ○ |
| SRO | Shoulder injury related to vaccine administration | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release