2KH-33419-85701
4 vaccinations
6 coded responses
27 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 917 / CA
- Registered
- 2021-01-20
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Registered dependents
89A-29603-28011
Child or adolescent in my care · Female · 2022-02-10
Timeline
-
2021-01-16
Dose 1 — Moderna
-
2021-01-20
Registered in v-safe
-
2021-02-10
Dose 2 — Moderna
-
2021-02-11
Survey response — days 1–6 daily, dose 2MedDRA: Back pain, Nipple pain — Feeling: Fair · Site: Pain, Swelling · Joint painsFree text: Nipples pain, back pain.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-11
Survey response — day 21, dose 1MedDRA: Axillary pain, Back pain, Constipation, Nipple pain — Feeling: FairFree text: Armpit sore, nipples sore, back pain and constipation.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-12
Survey response — days 1–6 daily, dose 2MedDRA: Constipation — Feeling: Good · Joint painsFree text: ConstipateMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-13
Survey response — days 1–6 daily, dose 2MedDRA: Constipation — Feeling: Good · Joint painsFree text: ConstipateMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-14
Survey response — days 1–6 daily, dose 2MedDRA: Constipation — Feeling: GoodFree text: ConstipateMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-24
- 2021-03-04
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-05-12
- 2021-08-11
-
2021-10-28
Dose 3 — Moderna
- 2022-02-10
- 2022-04-28
-
2022-09-21
Dose 4 — Moderna
- 2022-09-26
- 2022-09-27
-
2022-09-28
Survey response — day 7, dose 4MedDRA: Constipation — Feeling: GoodFree text: ConstipateMedDRA releases: 2024-11 · check-in free text available
- 2022-10-05
- 2022-10-12
- 2022-10-19
- 2022-10-26
- 2022-11-02
- 2022-12-21
- 2023-03-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-16 | Moderna | |
| 2 | 2021-02-10 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
| 4 | 2022-09-21 | Moderna | No |
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Nipples pain, back pain.
Release 4 — day 21, dose 1
Symptoms: Armpit sore, nipples sore, back pain and constipation.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Constipate
Systemic reaction (other): Constipate
Systemic reaction (other): Constipate
Release 12 — day 7, dose 4
Systemic reaction (other): Constipate
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 pain | ✓ | ✓ | ✓ |
| SD | Back pain | ✓ | ✓ | ✓ |
| SD | Constipation | ✓ | ✓ | ✓ |
| SD | Nipple pain | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Constipation | ✓ | ✓ | ✓ |
| SRO | Nipple pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release