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2VM-48348-97869

3 vaccinations 4 coded responses 26 check-ins 4 free-text entries 1 call case
Sex
Female
Age at first dose
61-65
ZIP prefix
200 / DC
Registered
2021-03-28
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-28
    Dose 1 — Moderna
  2. 2021-03-28
    Registered in v-safe
  3. 2021-03-28
    Dose 2 — Moderna
  4. 2021-03-28
    Health check-in — day 0, dose 2
    Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea
    Adult check-in
  5. 2021-03-29
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea
    Adult check-in
  6. 2021-03-30
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  7. 2021-03-31
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activities
    Adult check-in
  8. 2021-04-01
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Muscle or body aches
    Adult check-in
  9. 2021-04-02
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Muscle or body aches
    Adult check-in
  10. 2021-04-03
    Survey response — days 1–6 daily, dose 2
    MedDRA: Arthralgia, Back pain — Feeling: Good · Muscle or body aches
    Free text: Lower back and hip pain since second shot.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-04-04
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  12. 2021-04-11
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-04-18
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-04-27
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-05-04
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-05-09
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-06-27
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-09-26
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-10-27
    Dose 3 — Moderna
  20. 2021-10-29
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  21. 2021-10-30
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  22. 2021-11-01
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  23. 2021-11-03
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  24. 2021-11-11
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  25. 2021-11-17
    Survey response — day 21, dose 3
    MedDRA: Chills, Fatigue, Pain — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Two days feeling fatigued with slight chills and aches; no fever.
    MedDRA releases: 2024-11 · check-in free text available
  26. 2021-11-26
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  27. 2021-12-01
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  28. 2021-12-08
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  29. 2022-01-26
    Survey response — 3 months, dose 3
    MedDRA: Nasopharyngitis, Quarantine — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Cold symptoms. Attended an indoor event in which others are now testing positive. Antigen test this morning was negative but symptoms are worsening. We are presumptively quarantining.
    MedDRA releases: 2024-11 · check-in free text available
  30. 2022-04-27
    Survey response — 6 months, dose 3
    MedDRA: Quarantine, SARS-CoV-2 test positive — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Tested positive for Covid Jan 27 2022 after a family wedding. Isolated under (b)(6)Govt instructions for 10 days. Now fine.
    MedDRA releases: 2024-11 · check-in free text available
  31. 2022-04-27
    Report sent to call center — 6 months, dose 3
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Telehealth, virtual health, or email health consultation · 1 call case(s)
  32. 2022-04-29
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

DoseDateManufacturerCo-administered
12021-02-28Moderna
22021-03-28Moderna
32021-10-27Moderna No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 2

2021-04-03

Systemic reaction (other): Lower back and hip pain since second shot.

Release 10 — day 21, dose 3

2021-11-17

Symptoms: Two days feeling fatigued with slight chills and aches; no fever.

Release 11 — 3 months, dose 3

2022-01-26

Symptoms: Cold symptoms. Attended an indoor event in which others are now testing positive. Antigen test this morning was negative but symptoms are worsening. We are presumptively quarantining.

Release 11 — 6 months, dose 3

2022-04-27

Symptoms: Tested positive for Covid Jan 27 2022 after a family wedding. Isolated under (b)(6)Govt instructions for 10 days. Now fine.
redacted (b)(6)

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

FieldPreferred term2021-092023-042024-11
SDChills · · ✓
SDFatigue · · ✓
SDNasopharyngitis · · ✓
SDPain · · ✓
SDQuarantine · · ✓
SDSARS-CoV-2 test positive · · ✓
SROArthralgia ✓ ✓ ✓
SROBack pain ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release