28U-44498-05821
2 vaccinations
3 coded responses
25 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 757 / TX
- Registered
- 2021-04-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-10
Registered in v-safe
-
2021-04-10
Dose 1 — Moderna
- 2021-04-10
- 2021-04-11
- 2021-04-12
- 2021-04-13
- 2021-04-14
- 2021-04-15
- 2021-04-16
- 2021-04-17
-
2021-04-24
Survey response — day 14, dose 1MedDRA: Cough, Headache, Respiratory tract congestion — Feeling: PoorFree text: Headache, congestion and cough.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-01
Survey response — day 21, dose 1MedDRA: Abdominal distension, Gastroenteritis viral, Muscle spasms — Feeling: PoorFree text: I think its probably just a stomach virus. No fever but cramping and bloating.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-08
-
2021-05-14
Dose 2 — Moderna
- 2021-05-15
- 2021-05-16
- 2021-05-17
- 2021-05-18
- 2021-05-19
- 2021-05-20
- 2021-05-21
- 2021-05-28
- 2021-06-06
- 2021-06-11
- 2021-06-18
- 2021-06-25
-
2021-08-13
Survey response — 3 months, dose 2MedDRA: Clostridium difficile infection, Cough, Dysarthria, Dyspnoea, Gastric disorder, Nasopharyngitis, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Grandsons had RSV and I got a really bad cold that lasted two weeks and the cough lasted another couple of weeks. Also was having stomach problems and the PA diagnosed me with C-Diff. · Healthcare visit (other): Went to clinic but they sent me to my car to wait for a phone call. Already had an appointment for the stomach but they treated the cold since I was having difficulty breathing and talking.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-13
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-11-15
-
2021-12-09
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-10 | Moderna | |
| 2 | 2021-05-14 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 7 — day 14, dose 1
Symptoms: Headache, congestion and cough.
Release 8 — day 21, dose 1
Symptoms: I think its probably just a stomach virus. No fever but cramping and bloating.
Release 9 — 3 months, dose 2
Symptoms: Grandsons had RSV and I got a really bad cold that lasted two weeks and the cough lasted another couple of weeks. Also was having stomach problems and the PA diagnosed me with C-Diff.
Healthcare visit (other): Went to clinic but they sent me to my car to wait for a phone call. Already had an appointment for the stomach but they treated the cold since I was having difficulty breathing and talking.
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 | Dysarthria | ✓ | · | ✓ |
| HCVO | Dyspnoea | ✓ | · | ✓ |
| HCVO | Gastric disorder | ✓ | · | ✓ |
| HCVO | Nasopharyngitis | ✓ | · | ✓ |
| HCVO | Office visit | ✓ | · | ✓ |
| SD | Abdominal distension | ✓ | ✓ | ✓ |
| SD | Clostridium difficile infection | ✓ | · | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Gastric disorder | ✓ | · | ✓ |
| SD | Gastroenteritis viral | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Muscle spasms | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | ✓ | · | ✓ |
| SD | Office visit | ✓ | · | ✓ |
| SD | Respiratory tract congestion | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release