2YY-44416-03187
5 vaccinations
8 coded responses
47 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 530 / WI
- Registered
- 2021-02-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-02
Registered in v-safe
-
2021-02-02
Dose 1 — Moderna
- 2021-02-02
- 2021-02-05
- 2021-02-06
- 2021-02-07
- 2021-02-08
-
2021-02-09
Survey response — day 7, dose 1MedDRA: Nasal congestion, Oropharyngeal pain — Feeling: Good · Fatigue or tirednessFree text: Sore throat, stuffy nose.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-17
Survey response — day 14, dose 1MedDRA: Injection site pruritus, Injection site rash — Feeling: FairFree text: Slight rash and moderate to severe itchiness at injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-23
-
2021-03-02
Dose 2 — Moderna
- 2021-03-02
-
2021-03-03
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-03-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-05
- 2021-03-06
-
2021-03-07
Survey response — days 1–6 daily, dose 2MedDRA: Emergency care, Vertigo — Feeling: Fair · Headache, Nausea, Vomiting · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Systemic reaction (other): Extreme vertigo. Spent ladt last in the E.R. · Healthcare visit (other): Discharged from E.R. folliwing stroke work-up. CT with & without contrast negative. MRI negative. Discharged from E.R. with instructions to follow up with primary care physician tomorrow.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-07
Report sent to call center — days 1–6 daily, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-08
Survey response — days 1–6 daily, dose 2MedDRA: Malaise — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to workFree text: Overall malaise.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-09
Survey response — day 7, dose 2MedDRA: Tremor — Feeling: Good · HeadacheFree text: Feeling shaky.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-04-06
- 2021-04-13
- 2021-06-01
- 2021-08-31
-
2021-11-02
Dose 3 — Moderna
-
2021-12-06
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-03-04
-
2022-06-02
Dose 4 — Moderna
- 2022-06-04
- 2022-06-05
- 2022-06-07
- 2022-06-08
- 2022-06-09
- 2022-06-16
- 2022-06-23
- 2022-06-30
- 2022-07-07
- 2022-07-14
-
2022-09-01
Survey response — 3 months, dose 4MedDRA: Sinusitis — Feeling: GoodFree text: Sinus infection.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-24
Dose 5 — ModernaCo-administered: Flu
-
2022-10-26
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activitiesAdult check-in
- 2022-10-27
- 2022-10-28
- 2022-10-29
- 2022-10-31
- 2022-11-07
- 2022-11-14
- 2022-11-22
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2022-11-28
Survey response — day 35, dose 5MedDRA: Chills, Cough, Oropharyngeal pain, Pain, Respiratory tract congestion — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Cough, congestion, chills, body aches, sore throat.MedDRA releases: 2024-11 · check-in free text available
- 2022-12-05
-
2023-01-23
Survey response — 3 months, dose 5MedDRA: Bronchitis — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
- 2023-04-24
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-02 | Moderna | |
| 2 | 2021-03-02 | Moderna | |
| 3 | 2021-11-02 | Moderna | No |
| 4 | 2022-06-02 | Moderna | No |
| 5 | 2022-10-24 | Moderna | Flu |
Call center
1 call center case
1 successful
Free text
Release 3 — day 7, dose 1
Systemic reaction (other): Sore throat, stuffy nose.
Release 4 — day 14, dose 1
Symptoms: Slight rash and moderate to severe itchiness at injection site.
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Extreme vertigo. Spent ladt last in the E.R.
Healthcare visit (other): Discharged from E.R. folliwing stroke work-up. CT with & without contrast negative. MRI negative. Discharged from E.R. with instructions to follow up with primary care physician tomorrow.
Systemic reaction (other): Overall malaise.
Release 5 — day 7, dose 2
Systemic reaction (other): Feeling shaky.
Release 12 — 3 months, dose 4
Symptoms: Sinus infection.
Release 12 — day 35, dose 5
Symptoms: Cough, congestion, chills, body aches, sore throat.
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 | Emergency care | ✓ | ✓ | ✓ |
| SD | Bronchitis | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SRO | Emergency care | ✓ | ✓ | ✓ |
| SRO | Malaise | ✓ | ✓ | ✓ |
| SRO | Nasal congestion | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Tremor | ✓ | ✓ | ✓ |
| SRO | Vertigo | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release