28W-30780-97497
2 vaccinations
7 coded responses
23 check-ins
7 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 967 / HI
- Registered
- 2021-03-04
- Relationship
- Self
- Race
- American Indian or Alaska Native
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-03-04
Registered in v-safe
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2021-03-04
Dose 1 — Moderna
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2021-03-04
Survey response — day 0, dose 1MedDRA: Dizziness, Hypoaesthesia, Immediate post-injection reaction, Pain in extremity — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Arm that was injected had numbness in wrist and hand immediately after shot for 20 min, little dizziness. Now just pain throughout arm and handMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-05
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Headache, Muscle or body achesAdult check-in
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2021-03-06
Survey response — days 1–6 daily, dose 1MedDRA: Ear pain — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: Ear acheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-07
- 2021-03-08
- 2021-03-10
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2021-03-11
Health check-in — day 7, dose 1Feeling: Good · Headache · Be unable to do your normal daily activitiesAdult check-in
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2021-03-18
Survey response — day 14, dose 1MedDRA: Fatigue, Feeling abnormal, Headache — Feeling: Fair · Be unable to do your normal daily activitiesFree text: On and off Headaches, fatigue and mental fogginess. * may have been exposed to covid positive person at work waiting for their test results. Then going to get tested.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-25
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2021-04-01
Dose 2 — Moderna
- 2021-04-01
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2021-04-02
Survey response — days 1–6 daily, dose 2MedDRA: Pain in jaw, Toothache — Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesFree text: Pain in jaw and teethMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-03
Survey response — days 1–6 daily, dose 2MedDRA: Respiratory tract congestion — Feeling: Fair · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, NauseaFree text: A little congestionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Redness · Fever · Chills, Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
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2021-04-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-04-07
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2021-04-08
Survey response — day 7, dose 2MedDRA: Feeling abnormal — Feeling: Good · Fatigue or tirednessFree text: Foggy brainMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-17
- 2021-04-23
- 2021-04-29
- 2021-05-06
- 2021-05-15
- 2021-07-03
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2022-04-01
Survey response — 12 months, dose 2MedDRA: Fatigue, Menstrual disorder, Tinnitus — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Tinnitus, fatigue, changes in MenstruationMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-04 | Moderna | |
| 2 | 2021-04-01 | Moderna |
Free text
Release 5 — day 0, dose 1
Systemic reaction (other): Arm that was injected had numbness in wrist and hand immediately after shot for 20 min, little dizziness. Now just pain throughout arm and hand
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Ear ache
Release 5 — day 14, dose 1
Symptoms: On and off Headaches, fatigue and mental fogginess. * may have been exposed to covid positive person at work waiting for their test results. Then going to get tested.
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Pain in jaw and teeth
Systemic reaction (other): A little congestion
Release 7 — day 7, dose 2
Systemic reaction (other): Foggy brain
Release 11 — 12 months, dose 2
Symptoms: Tinnitus, fatigue, changes in Menstruation
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 |
|---|---|---|---|---|
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Feeling abnormal | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Menstrual disorder | · | · | ✓ |
| SD | Tinnitus | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Ear pain | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Pain in jaw | ✓ | ✓ | ✓ |
| SRO | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SRO | Toothache | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release