327-21642-40521
4 vaccinations
7 coded responses
25 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 801 / CO
- Registered
- 2021-04-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
NF2-12271-58179
Child or adolescent in my care · Male · 2022-10-23
Timeline
-
2021-03-20
Dose 1 — Moderna
-
2021-04-16
Registered in v-safe
- 2021-04-16
-
2021-04-17
Dose 2 — Moderna
- 2021-04-17
-
2021-04-18
Survey response — days 1–6 daily, dose 2MedDRA: Asthma, Chills, Pain, Pain in extremity, Retching, Vomiting — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to do your normal daily activitiesFree text: I woke up to throwing up and dry heaving for over an hour. Not Fun! :( Still glad i got it!! Ill be fine. Better this evening with my stomach. Some asthma kicking up and chills, pain. Need a good nights sleep!!!MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-19
Survey response — days 1–6 daily, dose 2MedDRA: Abdominal discomfort, Headache — Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Doing better today. Still have headache & upset stomach. Feeling better than yesterday ..MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-20
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Good · Site: Pain, Redness · Headache, Fatigue or tiredness, NauseaFree text: Much better today!!!! :)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-21
Survey response — days 1–6 daily, dose 2MedDRA: Pre-existing disease — Feeling: Good · Site: Pain, Redness, Itching · Fatigue or tirednessFree text: Feeling much better! One thing occurred to me. Im on HRT. I had just gotten my estrogen & testosterone pellets the week before. Makes me wonder if that had something to do with my severe symptoms after the 2nd shot? Just food for thought. :)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-22
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Good · Site: Itching · NauseaFree text: Yay!!! Feeling better..MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-23
- 2021-04-24
- 2021-05-01
- 2021-05-08
- 2021-05-15
- 2021-05-22
- 2021-05-29
- 2021-07-17
- 2021-10-16
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2021-11-19
Dose 3 — Moderna
- 2022-04-17
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2022-09-18
Dose 4 — ModernaCo-administered: Flu
- 2022-09-28
- 2022-10-02
- 2022-10-09
- 2022-10-16
- 2022-10-23
- 2022-10-30
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2022-12-18
Survey response — 3 months, dose 4MedDRA: Chills, Influenza like illness, Malaise, Nasal congestion, Pyrexia — Feeling: Good · Be unable to do your normal daily activitiesFree text: Sick. No covid. Fever chills, fluish. Stuffy noseMedDRA releases: 2024-11 · check-in free text available
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2023-03-19
Survey response — 6 months, dose 4MedDRA: Ventricular tachycardia — Feeling: FairMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-20 | Moderna | |
| 2 | 2021-04-17 | Moderna | |
| 3 | 2021-11-19 | Moderna | No |
| 4 | 2022-09-18 | Moderna | Flu |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): I woke up to throwing up and dry heaving for over an hour. Not Fun! :( Still glad i got it!! Ill be fine. Better this evening with my stomach. Some asthma kicking up and chills, pain. Need a good nights sleep!!!
Systemic reaction (other): Doing better today. Still have headache & upset stomach. Feeling better than yesterday ..
Systemic reaction (other): Much better today!!!! :)
Systemic reaction (other): Feeling much better! One thing occurred to me. Im on HRT. I had just gotten my estrogen & testosterone pellets the week before. Makes me wonder if that had something to do with my severe symptoms after the 2nd shot? Just food for thought. :)
Systemic reaction (other): Yay!!! Feeling better..
Release 12 — 3 months, dose 4
Symptoms: Sick. No covid. Fever chills, fluish. Stuffy nose
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 | Chills | · | · | ✓ |
| SD | Influenza like illness | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Ventricular tachycardia | · | · | ✓ |
| SRO | Abdominal discomfort | ✓ | ✓ | ✓ |
| SRO | Asthma | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Retching | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Vomiting | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release