2JE-28388-50260
3 vaccinations
4 coded responses
23 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 627 / IL
- Registered
- 2020-12-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-28
Registered in v-safe
-
2020-12-28
Dose 1 — Moderna
- 2020-12-28
-
2020-12-29
Survey response — days 1–6 daily, dose 1MedDRA: Headache, Immediate post-injection reaction — Feeling: Fair · Site: Pain · HeadacheFree text: Bad Headache yesterday also within 30 minutes of injection. I was unable to go back and change my report.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2020-12-30
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
-
2021-01-25
Dose 2 — Moderna
- 2021-01-25
-
2021-01-26
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-01-27
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Itching · Fatigue or tirednessAdult check-in
- 2021-01-28
-
2021-01-29
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: GoodFree text: 1st 2 days felt dizzy with movement and didnt report it until others said they had the same.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-30
- 2021-02-01
- 2021-02-08
- 2021-02-15
- 2021-02-22
-
2021-03-01
Survey response — day 35, dose 2MedDRA: Axillary mass, Axillary pain — Feeling: GoodFree text: Small lump/lymph node in left axillary that was extremely sore for the first 2 days. Soreness has gone but lump remains. About the size of my pinky fingertip or a large pea.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-08
- 2021-04-26
- 2021-07-26
-
2021-12-07
Dose 3 — Moderna
-
2022-01-25
Survey response — 12 months, dose 2MedDRA: Cough, Fatigue, Oropharyngeal pain, Sinus pain, Upper-airway cough syndrome — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Sinus pain, post nasal drip ,sore throat,cough l. Feeling tired run down today.MedDRA releases: 2024-11 · check-in free text available
-
2022-01-25
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-01-26
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Moderna | |
| 2 | 2021-01-25 | Moderna | |
| 3 | 2021-12-07 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Bad Headache yesterday also within 30 minutes of injection. I was unable to go back and change my report.
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): 1st 2 days felt dizzy with movement and didnt report it until others said they had the same.
Release 4 — day 35, dose 2
Symptoms: Small lump/lymph node in left axillary that was extremely sore for the first 2 days. Soreness has gone but lump remains. About the size of my pinky fingertip or a large pea.
Release 11 — 12 months, dose 2
Symptoms: Sinus pain, post nasal drip ,sore throat,cough l. Feeling tired run down today.
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 | Axillary mass | ✓ | ✓ | ✓ |
| SD | Axillary pain | ✓ | ✓ | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Sinus pain | · | · | ✓ |
| SD | Upper-airway cough syndrome | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release