275-15190-03286
2 vaccinations
2 coded responses
20 check-ins
2 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 920 / CA
- Registered
- 2021-10-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-10-12
Registered in v-safe
-
2021-10-12
Dose 1 — Moderna
- 2021-10-12
-
2021-10-13
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain, Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
-
2021-10-14
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
-
2021-10-15
Survey response — days 1–6 daily, dose 1MedDRA: Immunisation reaction, Injection site rash — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body achesFree text: Covid Arm": Rash near injection siteMedDRA releases: 2024-11 · check-in free text available
-
2021-10-16
Survey response — days 1–6 daily, dose 1MedDRA: Dry skin, Epistaxis, Paraesthesia, Paranasal sinus hyposecretion, Pruritus — Feeling: Fair · Site: Pain, Redness, ItchingFree text: Tingling and itchiness throughout entire body, very dry skin. Very dry sinuses, nosebleed.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-18
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Redness, Itching · NoneAdult check-in
- 2021-10-21
- 2021-10-26
-
2021-12-27
Dose 2 — Moderna
-
2021-12-28
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness, Swelling · 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 activitiesAdult check-in
-
2021-12-29
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend schoolAdult check-in
- 2021-12-30
- 2022-01-01
- 2022-01-02
- 2022-01-03
- 2022-01-10
- 2022-01-17
- 2022-01-24
- 2022-01-31
- 2022-02-07
- 2022-03-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-10-12 | Moderna | No |
| 2 | 2021-12-27 | Moderna | No |
Free text
Release 10 — days 1–6 daily, dose 1
Systemic reaction (other): Covid Arm": Rash near injection site
Systemic reaction (other): Tingling and itchiness throughout entire body, very dry skin. Very dry sinuses, nosebleed.
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 |
|---|---|---|---|---|
| SRO | Dry skin | · | · | ✓ |
| SRO | Epistaxis | · | · | ✓ |
| SRO | Immunisation reaction | · | · | ✓ |
| SRO | Injection site rash | · | · | ✓ |
| SRO | Paraesthesia | · | · | ✓ |
| SRO | Paranasal sinus hyposecretion | · | · | ✓ |
| SRO | Pruritus | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release