2M6-18809-23193
2 vaccinations
4 coded responses
20 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 486 / MI
- Registered
- 2021-03-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-04
Dose 1 — Moderna
-
2021-03-05
Registered in v-safe
-
2021-03-05
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Chills, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-06
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: GoodFree text: Yesterday after I submitted how do I feel.Yesterday, late afternoon, I did have a fever of 100.1 for six hours.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-07
- 2021-03-08
- 2021-03-11
-
2021-03-18
Survey response — day 14, dose 1MedDRA: Breast disorder, COVID-19 — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: They found something in my breast and I now have to have a breast biopsy. Dont know if thats related to having COVID-19 and the vaccine. Just thought Id let you knowMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-18
Report sent to call center — day 14, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-25
-
2021-04-01
Dose 2 — Moderna
- 2021-04-01
-
2021-04-02
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-03
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2021-04-04
Survey response — days 1–6 daily, dose 2MedDRA: Diarrhoea — Feeling: Good · DiarrheaFree text: Its not necessary diarrhea but its definitely loose bowels and Ive had it ever since I got the vaccine. Its just like when I had covered its the same side effect.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-15
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2021-04-22
Survey response — day 21, dose 2MedDRA: Breast cancer, Breast operation, SARS-CoV-2 test negative — Feeling: Fair · Be unable to do your normal daily activitiesFree text: I had to have a COVID-19 test and it was negative the reason for the test was I had to have breast cancer surgery today. So thats why Im not feeling good.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-01
- 2021-10-02
-
2021-12-22
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-04-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-04 | Moderna | |
| 2 | 2021-04-01 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Yesterday after I submitted how do I feel.Yesterday, late afternoon, I did have a fever of 100.1 for six hours.
Release 5 — day 14, dose 1
Symptoms: They found something in my breast and I now have to have a breast biopsy. Dont know if thats related to having COVID-19 and the vaccine. Just thought Id let you know
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Its not necessary diarrhea but its definitely loose bowels and Ive had it ever since I got the vaccine. Its just like when I had covered its the same side effect.
Release 7 — day 21, dose 2
Symptoms: I had to have a COVID-19 test and it was negative the reason for the test was I had to have breast cancer surgery today. So thats why Im not feeling good.
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 | Breast cancer | ✓ | ✓ | ✓ |
| SD | Breast disorder | ✓ | ✓ | ✓ |
| SD | Breast operation | ✓ | ✓ | ✓ |
| SD | COVID-19 | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SRO | Diarrhoea | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release