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24V-72206-63464

3 vaccinations 8 coded responses 21 check-ins 8 free-text entries 0 call cases
Sex
Female
Age at first dose
51-55
ZIP prefix
723 / AR
Registered
2021-01-21
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino
Registered dependents
XNP-25333-66084 Child or adolescent in my care · Male · 2022-04-26
C4F-23824-85943 Child or adolescent in my care · Male · 2022-04-26

Timeline

  1. 2021-01-12
    Dose 1 — Moderna
  2. 2021-01-21
    Registered in v-safe
  3. 2021-01-21
    Health check-in — day 7, dose 1
    Feeling: Fair · Site: Pain · Nausea
    Adult check-in
  4. 2021-01-26
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  5. 2021-02-02
    Survey response — day 21, dose 1
    MedDRA: Abdominal pain — Feeling: Fair
    Free text: I have pain in my abdomen. I will be testing to rule out gallstones before I blame the shot.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-09
    Dose 2 — Moderna
  7. 2021-02-09
    Survey response — day 0, dose 2
    MedDRA: Asthma, Pre-existing disease — Feeling: Fair · Headache
    Free text: Mild asthma attack
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-02-10
    Survey response — days 1–6 daily, dose 2
    MedDRA: Hypoaesthesia — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness
    Free text: My hand went numb for about 30 minutes.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-02-11
    Survey response — days 1–6 daily, dose 2
    MedDRA: Hypoaesthesia — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: My hand gets numb even if my arm is straight.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-02-12
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Swelling, Itching · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  11. 2021-02-13
    Survey response — days 1–6 daily, dose 2
    MedDRA: Hypoaesthesia — Feeling: Good · Site: Swelling, Itching · Muscle or body aches, Fatigue or tiredness
    Free text: Intermittent numbness in my arm and hand in injection side.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-02-14
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Itching · Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  13. 2021-02-15
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Itching · Fatigue or tiredness
    Adult check-in
  14. 2021-02-16
    Survey response — day 7, dose 2
    MedDRA: Condition aggravated, Fatigue, Pre-existing disease — Feeling: Good · Joint pains, Fatigue or tiredness
    Free text: I suffer from peripheral neuropathy as a breast cancer survivor. My neuropathy has been flailing more since the shot. I am more fatigued due to this.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-02-23
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-03-02
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-03-09
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-03-16
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-03-23
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-05-11
    Survey response — 3 months, dose 2
    MedDRA: Asthma, Pre-existing disease — Feeling: Good
    Free text: More asthma attacks
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-08-10
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-11-05
    Dose 3 — Moderna
  23. 2022-02-09
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in
  24. 2022-05-06
    Survey response — 6 months, dose 3
    MedDRA: Adverse food reaction — Feeling: Good
    Free text: I have developed a sensitivity to peanuts.
    MedDRA releases: 2024-11 · check-in free text available
  25. 2022-11-05
    Health check-in — 12 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-12Moderna
22021-02-09Moderna
32021-11-05Moderna No

Free text

Release 3 — day 21, dose 1

2021-02-02

Symptoms: I have pain in my abdomen. I will be testing to rule out gallstones before I blame the shot.

Release 3 — day 0, dose 2

2021-02-09

Systemic reaction (other): Mild asthma attack

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): My hand went numb for about 30 minutes.

2021-02-11

Systemic reaction (other): My hand gets numb even if my arm is straight.

2021-02-13

Systemic reaction (other): Intermittent numbness in my arm and hand in injection side.

Release 4 — day 7, dose 2

2021-02-16

Systemic reaction (other): I suffer from peripheral neuropathy as a breast cancer survivor. My neuropathy has been flailing more since the shot. I am more fatigued due to this.

Release 8 — 3 months, dose 2

2021-05-11

Symptoms: More asthma attacks

Release 11 — 6 months, dose 3

2022-05-06

Symptoms: I have developed a sensitivity to peanuts.

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 pain ✓ ✓ ✓
SDAdverse food reaction · · ✓
SDAsthma ✓ ✓ ✓
SDPre-existing disease ✓ ✓ ✓
SROAsthma ✓ ✓ ✓
SROCondition aggravated ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROHypoaesthesia ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓

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