2AH-30536-61190
3 vaccinations
3 coded responses
13 check-ins
3 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 546 / WI
- Registered
- 2021-04-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-03
Dose 1 — Moderna
-
2021-04-10
Registered in v-safe
-
2021-04-10
Dose 2 — Moderna
-
2021-04-10
Health check-in — day 0, dose 2Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, DiarrheaAdult check-in
- 2021-04-11
- 2021-04-12
- 2021-04-13
- 2021-04-15
- 2021-04-16
- 2021-04-17
- 2021-04-24
-
2021-05-01
Survey response — day 21, dose 2MedDRA: Diarrhoea, Dyspnoea — Feeling: FairFree text: Hard to catch my breath, and still have diarrhea.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-15
- 2021-05-22
-
2021-05-25
Pregnancy registry surveyNot pregnant at or since vaccination ·
-
2021-09-01
Dose 3 — Pfizer-BioNTech
-
2021-10-09
Survey response — 6 months, dose 2MedDRA: Asthenia, Hospitalisation, Ileostomy, Infection, Weight decreased — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: I ended up contracting some type of infection was in the hospital for over a month ended up getting having to have a ileostomy put in Lost over 80 lb and dealing with that continual weight loss. And have no energy.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-01
Survey response — 3 months, dose 3MedDRA: Cardio-respiratory arrest, Clostridium difficile infection, Hospitalisation, Ileostomy, Megacolon, Pneumonia, Sepsis, Surgery, Weight decreased — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: I have had septice which turned into megacolon, which turned into C-DIF. Had to have 3 major surgeries, (coded twice on the table), resulting in an ileostomy. Since then have lost 90+lbs. Hospitalized w/pneumonia. Know one knows cause.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-03 | Moderna | |
| 2 | 2021-04-10 | Moderna | |
| 3 | 2021-09-01 | Pfizer-BioNTech | No |
Free text
Release 8 — day 21, dose 2
Symptoms: Hard to catch my breath, and still have diarrhea.
Release 10 — 6 months, dose 2
Symptoms: I ended up contracting some type of infection was in the hospital for over a month ended up getting having to have a ileostomy put in Lost over 80 lb and dealing with that continual weight loss. And have no energy.
Release 10 — 3 months, dose 3
Symptoms: I have had septice which turned into megacolon, which turned into C-DIF. Had to have 3 major surgeries, (coded twice on the table), resulting in an ileostomy. Since then have lost 90+lbs. Hospitalized w/pneumonia. Know one knows cause.
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 | Asthenia | · | · | ✓ |
| SD | Cardio-respiratory arrest | · | · | ✓ |
| SD | Clostridium difficile infection | · | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Ileostomy | · | · | ✓ |
| SD | Infection | · | · | ✓ |
| SD | Megacolon | · | · | ✓ |
| SD | Pneumonia | · | · | ✓ |
| SD | Sepsis | · | · | ✓ |
| SD | Surgery | · | · | ✓ |
| SD | Weight decreased | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release