2KG-22751-00105
4 vaccinations
5 coded responses
54 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 967 / HI
- Registered
- 2021-01-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-13
Dose 1 — Moderna
-
2021-01-14
Registered in v-safe
- 2021-01-14
-
2021-01-15
Survey response — days 1–6 daily, dose 1MedDRA: Cough, Facial pain, Fatigue, Immediate post-injection reaction, Influenza like illness, Pre-existing disease, Sinusitis — Feeling: Good · Fatigue or tirednessFree text: During my 15 minute observation I felt a "pinching" in my face that reminded me of a pinching feeling between my eyes last Feb2020. At that time I developed flu-like symptoms but tested negative for flu. I was treated successfully for sinus infection a week after first symptoms developed, and got over it fairly quickly. Vague fatigue persisted for a week or so, and my dry cough lasted a full 2 months. I wonder if I'd had Covid that long ago, though it was not thought to be here ((b)(6)) at that time.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-20
- 2021-01-27
- 2021-02-03
-
2021-02-10
Dose 2 — Moderna
-
2021-02-10
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body achesAdult check-in
-
2021-02-11
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Swelling · Headache, Muscle or body achesAdult check-in
-
2021-02-12
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Swelling · Chills, Muscle or body achesAdult check-in
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-24
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-05-12
- 2021-08-11
-
2021-10-23
Dose 3 — Moderna
- 2021-10-23
-
2021-10-24
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-10-25
- 2021-10-26
- 2021-10-27
- 2021-10-28
-
2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Good · Chills, Diarrhea, Abdominal painAdult check-in
- 2021-10-30
- 2021-11-06
- 2021-11-13
- 2021-11-20
- 2021-11-27
- 2021-12-04
- 2022-01-22
-
2022-04-14
Dose 4 — Moderna
- 2022-04-14
-
2022-04-15
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Headache, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
- 2022-04-16
- 2022-04-17
- 2022-04-18
- 2022-04-19
- 2022-04-20
- 2022-04-21
- 2022-04-28
- 2022-05-05
- 2022-05-12
- 2022-05-19
-
2022-05-26
Survey response — day 42, dose 4MedDRA: Malignant melanoma of eyelid, Surgery — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Diagnosis of melanoma to eye · Healthcare visit (other): Out pt surgeryMedDRA releases: 2024-11 · check-in free text available
-
2022-05-26
Report sent to call center — day 42, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2022-05-27
-
2022-07-14
Survey response — 3 months, dose 4MedDRA: Ocular melanoma, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Ocular melanoma · Healthcare visit (other): Scheduled for radiationMedDRA releases: 2024-11 · check-in free text available
-
2022-07-14
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-07-15
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-07-15
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-10-13
Survey response — 6 months, dose 4MedDRA: Ocular melanoma, Radiotherapy, Surgery — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Ocular melanoma · Healthcare visit (other): Same day surgery and radiationMedDRA releases: 2024-11 · check-in free text available
-
2022-10-13
Report sent to call center — 6 months, dose 4Get care from a doctor or other healthcare professional1 call case(s)
-
2022-10-14
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2023-04-14
Survey response — 12 months, dose 4MedDRA: Nasopharyngitis — Feeling: FairMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-13 | Moderna | |
| 2 | 2021-02-10 | Moderna | |
| 3 | 2021-10-23 | Moderna | No |
| 4 | 2022-04-14 | Moderna | No |
Call center
3 call center cases
3 successful
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): During my 15 minute observation I felt a "pinching" in my face that reminded me of a pinching feeling between my eyes last Feb2020. At that time I developed flu-like symptoms but tested negative for flu. I was treated successfully for sinus infection a week after first symptoms developed, and got over it fairly quickly. Vague fatigue persisted for a week or so, and my dry cough lasted a full 2 months. I wonder if I'd had Covid that long ago, though it was not thought to be here ((b)(6)) at that time.
redacted (b)(6)
Release 11 — day 42, dose 4
Release 12 — 3 months, dose 4
Release 12 — 6 months, dose 4
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 | Radiotherapy | · | · | ✓ |
| HCVO | Surgery | · | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Malignant melanoma of eyelid | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Ocular melanoma | · | · | ✓ |
| SRO | Cough | ○ | ✓ | ○ |
| SRO | Facial pain | ✓ | · | ✓ |
| SRO | Fatigue | ○ | ✓ | ○ |
| SRO | Immediate post-injection reaction | ✓ | · | ✓ |
| SRO | Influenza like illness | ○ | ✓ | ○ |
| SRO | Pre-existing disease | ✓ | · | ✓ |
| SRO | Sinusitis | ○ | ✓ | ○ |
✓ active code · ○ coded but marked inactive · blank = not in that release