2FV-19408-22902
2 vaccinations
7 coded responses
23 check-ins
7 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 690 / NE
- Registered
- 2021-08-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-08-27
Registered in v-safe
-
2021-08-27
Dose 1 — ModernaCo-administered: Tetanus
- 2021-08-27
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2021-08-28
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness, Malaise — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessFree text: Little lightheaded and feeling out of sorts but nothing major at this pointMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-29
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness, Malaise — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Light headed, out of sortsMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-30
Survey response — days 1–6 daily, dose 1MedDRA: Dry mouth — Feeling: Fair · Site: Pain · Fatigue or tirednessFree text: Severe dry mouthMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-09-01
Health check-in — days 1–6 daily, dose 1Feeling: Good · Headache, Fatigue or tirednessAdult check-in
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2021-09-02
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-09-03
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2021-09-10
Survey response — day 14, dose 1MedDRA: Blister, Injection site reaction, Pain in extremity, Pre-existing disease, Rash, Rash erythematous, Skin warm, Urticaria — Feeling: GoodFree text: 9/4- hives broke out at injection site in 3 in. circle. They got huge & blistery rest of day. Warm to touch. Became large red painful rash-like bumps & arm sore for days. Im Celiac, was accidentally glutened 9/4 & wondered if that triggered reactiMedDRA releases: 2024-11 · check-in free text available
- 2021-09-18
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2021-09-24
Dose 2 — Moderna
- 2021-09-24
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2021-09-25
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness, Abdominal painAdult check-in
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2021-09-26
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
- 2021-09-27
- 2021-09-28
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2021-09-29
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-09-30
- 2021-10-01
- 2021-10-10
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2021-10-15
Survey response — day 21, dose 2MedDRA: Headache, Nasal congestion, Paranasal sinus discomfort — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Sinus pressure, congested nose, headacheMedDRA releases: 2024-11 · check-in free text available
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2021-10-22
Survey response — day 28, dose 2MedDRA: Eye swelling, Headache, Paranasal sinus discomfort, Sinus congestion, Throat irritation — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Raw scratchy throat, sinus pressure and congestion, swollen eyes, horrible headachesMedDRA releases: 2024-11 · check-in free text available
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2021-10-29
Survey response — day 35, dose 2MedDRA: Fatigue, Headache, Respiratory tract congestion, Sneezing — Feeling: FairFree text: Congestion, sneezing, headaches, tiredMedDRA releases: 2024-11 · check-in free text available
- 2021-11-06
- 2021-12-24
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-08-27 | Moderna | Tetanus |
| 2 | 2021-09-24 | Moderna | No |
Free text
Release 9 — days 1–6 daily, dose 1
Systemic reaction (other): Little lightheaded and feeling out of sorts but nothing major at this point
Systemic reaction (other): Light headed, out of sorts
Systemic reaction (other): Severe dry mouth
Release 9 — day 14, dose 1
Symptoms: 9/4- hives broke out at injection site in 3 in. circle. They got huge & blistery rest of day. Warm to touch. Became large red painful rash-like bumps & arm sore for days. Im Celiac, was accidentally glutened 9/4 & wondered if that triggered reacti
Release 10 — day 21, dose 2
Symptoms: Sinus pressure, congested nose, headache
Release 10 — day 28, dose 2
Symptoms: Raw scratchy throat, sinus pressure and congestion, swollen eyes, horrible headaches
Release 10 — day 35, dose 2
Symptoms: Congestion, sneezing, headaches, tired
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 | Blister | · | · | ✓ |
| SD | Eye swelling | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Injection site reaction | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Paranasal sinus discomfort | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Rash erythematous | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SD | Skin warm | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SD | Throat irritation | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
| SRO | Dizziness | ✓ | · | ✓ |
| SRO | Dry mouth | ✓ | · | ✓ |
| SRO | Malaise | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release