2KY-17189-04713
5 vaccinations
6 coded responses
46 check-ins
6 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 236 / VA
- Registered
- 2021-02-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-30
Dose 1 — Moderna
-
2021-02-08
Registered in v-safe
- 2021-02-08
- 2021-02-13
-
2021-02-20
Survey response — day 21, dose 1MedDRA: Injection site pruritus, Injection site rash — Feeling: GoodFree text: Got a big rash around the injection site and it was itching. It came one week after my 1st dose. It faded after several days.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-27
Dose 2 — Moderna
- 2021-02-27
-
2021-02-28
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fever · Fatigue or tirednessAdult check-in
-
2021-03-01
Health check-in — days 1–6 daily, dose 2Feeling: Good · Fever · Fatigue or tirednessAdult check-in
-
2021-03-02
Survey response — days 1–6 daily, dose 2MedDRA: Decreased appetite — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Lack appetiteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-03
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-13
- 2021-03-20
-
2021-03-27
Survey response — day 28, dose 2MedDRA: Dry eye, Eye pruritus, Eyelid pain, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Behind Eye lids I have had pain and itching eyes. Saw eye dr yesterday who told me to put tears as much as I need all day and put a drop of dry eye creme in each eye at night. Today it is better. Dont know if vaccine related. Had dose 2 on Feb 27. · Healthcare visit (other): Dr office visitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-27
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-03
- 2021-04-10
- 2021-05-29
- 2021-08-28
-
2021-10-23
Dose 3 — Moderna
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-11-06
- 2021-11-13
- 2021-11-20
- 2021-11-27
- 2021-12-04
-
2022-01-19
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-01-22
-
2022-04-05
Dose 4 — Moderna
- 2022-04-18
- 2022-04-19
- 2022-04-26
- 2022-05-03
- 2022-05-10
- 2022-05-17
- 2022-07-05
-
2022-09-29
Dose 5 — Pfizer-BioNTech
-
2022-10-03
Survey response — days 1–6 daily, dose 5MedDRA: No adverse event — Feeling: GoodFree text:MedDRA releases: 2024-11 · check-in free text available
- 2022-10-04
- 2022-10-05
- 2022-10-06
- 2022-10-13
- 2022-10-20
- 2022-10-27
- 2022-11-03
-
2022-11-10
Survey response — day 42, dose 5MedDRA: Craniofacial fracture, Diplopia, Eye disorder, Face injury, Fall, Lip injury, Wrist fracture — Feeling: GoodFree text: I fell, on my face. Broke wrist and nose and lips. Have eye issues too, double vision in one eye.MedDRA releases: 2024-11 · check-in free text available
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2022-12-29
Survey response — 3 months, dose 5MedDRA: COVID-19, Cough, Oropharyngeal pain, Pyrexia — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Cough, sore throat, fever Positive for COVID!MedDRA releases: 2024-11 · check-in free text available
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2022-12-29
Report sent to call center — 3 months, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-12-30
Call successfulNot applicable - Accidental Reporting
- 2023-03-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-30 | Moderna | |
| 2 | 2021-02-27 | Moderna | |
| 3 | 2021-10-23 | Moderna | No |
| 4 | 2022-04-05 | Moderna | No |
| 5 | 2022-09-29 | Pfizer-BioNTech | No |
Call center
2 call center cases
2 successful
Free text
Release 4 — day 21, dose 1
Symptoms: Got a big rash around the injection site and it was itching. It came one week after my 1st dose. It faded after several days.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Lack appetite
Release 6 — day 28, dose 2
Symptoms: Behind Eye lids I have had pain and itching eyes. Saw eye dr yesterday who told me to put tears as much as I need all day and put a drop of dry eye creme in each eye at night. Today it is better. Dont know if vaccine related. Had dose 2 on Feb 27.
Healthcare visit (other): Dr office visit
Release 12 — days 1–6 daily, dose 5
Release 12 — day 42, dose 5
Symptoms: I fell, on my face. Broke wrist and nose and lips. Have eye issues too, double vision in one eye.
Release 12 — 3 months, dose 5
Symptoms: Cough, sore throat, fever Positive for COVID!
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 | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Craniofacial fracture | · | · | ✓ |
| SD | Diplopia | · | · | ✓ |
| SD | Dry eye | ✓ | ✓ | ✓ |
| SD | Eye disorder | · | · | ✓ |
| SD | Eye pruritus | ✓ | ✓ | ✓ |
| SD | Eyelid pain | ✓ | ✓ | ✓ |
| SD | Face injury | · | · | ✓ |
| SD | Fall | · | · | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SD | Lip injury | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Wrist fracture | · | · | ✓ |
| SRO | Decreased appetite | ✓ | ✓ | ✓ |
| SRO | No adverse event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release