2KJ-52914-83080
1 vaccination
3 coded responses
12 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 110 / NY
- Registered
- 2021-02-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-19
Dose 1 — Moderna
-
2021-02-20
Registered in v-safe
- 2021-02-20
-
2021-02-21
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Redness, Swelling · NoneAdult check-in
-
2021-02-22
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Redness, Swelling · NoneAdult check-in
- 2021-02-23
- 2021-02-24
- 2021-02-25
-
2021-02-27
Survey response — day 7, dose 1MedDRA: Rhinorrhoea — Feeling: Good · Site: ItchingFree text: Sniffles, ruunny nose...mildMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-05
- 2021-03-12
- 2021-05-21
-
2021-08-20
Survey response — 6 months, dose 1MedDRA: Headache, Respiratory tract congestion, Rhinorrhoea — Feeling: FairFree text: Head congestion...running nose. Suspect humidity..never had this before my life. Has been happening daily for awhile. Headachy. No smell or taste bud issues.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2022-02-20
Survey response — 12 months, dose 1MedDRA: Condition aggravated, Office visit, Paranasal sinus discomfort, Pre-existing disease, Rhinorrhoea — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Have hx. Of ablation for af 2015/after 3rd maderna had reoccurance of af. Continue to have intermittant forehead, like sinus pressure, runny nose,never had before vac. but have had stufffy nose in past. My #3 maderna was a full dose according to cvs · Healthcare visit (other): MD follow upMedDRA releases: 2024-11 · check-in free text available
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2022-02-20
Report sent to call center — 12 months, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2022-02-22
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-19 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 4 — day 7, dose 1
Systemic reaction (other): Sniffles, ruunny nose...mild
Release 9 — 6 months, dose 1
Symptoms: Head congestion...running nose. Suspect humidity..never had this before my life. Has been happening daily for awhile. Headachy. No smell or taste bud issues.
Release 11 — 12 months, dose 1
Symptoms: Have hx. Of ablation for af 2015/after 3rd maderna had reoccurance of af. Continue to have intermittant forehead, like sinus pressure, runny nose,never had before vac. but have had stufffy nose in past. My #3 maderna was a full dose according to cvs cut off by CDC
Healthcare visit (other): MD follow up
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 | Office visit | · | · | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | Headache | ✓ | · | ✓ |
| SD | Paranasal sinus discomfort | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Respiratory tract congestion | ✓ | · | ✓ |
| SD | Rhinorrhoea | ✓ | · | ✓ |
| SRO | Rhinorrhoea | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release