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33W-25614-11266

2 vaccinations 5 coded responses 25 check-ins 5 free-text entries 0 call cases
Sex
Female
Age at first dose
61-65
ZIP prefix
981 / WA
Registered
2021-01-31
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-31
    Registered in v-safe
  2. 2021-01-31
    Dose 1 — Moderna
  3. 2021-01-31
    Health check-in — day 0, dose 1
    Feeling: Fair · Site: Pain · Headache
    Adult check-in
  4. 2021-02-01
    Survey response — days 1–6 daily, dose 1
    MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain, Itching · Headache · Be unable to do your normal daily activities
    Free text: Just spacy - kind of out of it
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-02-02
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Itching · Headache
    Adult check-in
  6. 2021-02-03
    Survey response — days 1–6 daily, dose 1
    MedDRA: Headache, Pruritus — Feeling: Good
    Free text: At night is when i feel side effects:itchy arm and slight headache
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-02-05
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-02-06
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-02-07
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-02-14
    Survey response — day 14, dose 1
    MedDRA: Injection site rash, Rash pruritic — Feeling: Good
    Free text: I got a really itchy rash by injection site - lasted a fee days better now - i got shot on top of tattoo? Dont know if thats why
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-02-21
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-02-28
    Dose 2 — Moderna
  13. 2021-02-28
    Health check-in — day 0, dose 2
    Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Adult check-in
  14. 2021-03-01
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Adult check-in
  15. 2021-03-02
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  16. 2021-03-03
    Survey response — days 1–6 daily, dose 2
    MedDRA: Unevaluable event — Feeling: Poor · Site: Pain · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Free text: Yeah i am really weepy - maybe its knowing the worst of this pandemic is over for me means i can just let go of keeping it together
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-03-04
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  18. 2021-03-05
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-03-06
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-03-07
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  21. 2021-03-14
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-03-21
    Survey response — day 21, dose 2
    MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Just tired - might be incessant gray in (b)(6)
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  23. 2021-03-28
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-04-04
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-04-11
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-05-30
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-08-29
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  28. 2022-02-28
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-31Moderna
22021-02-28Moderna

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-01

Systemic reaction (other): Just spacy - kind of out of it

2021-02-03

Systemic reaction (other): At night is when i feel side effects:itchy arm and slight headache

Release 4 — day 14, dose 1

2021-02-14

Symptoms: I got a really itchy rash by injection site - lasted a fee days better now - i got shot on top of tattoo? Dont know if thats why

Release 4 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): Yeah i am really weepy - maybe its knowing the worst of this pandemic is over for me means i can just let go of keeping it together

Release 6 — day 21, dose 2

2021-03-21

Symptoms: Just tired - might be incessant gray in (b)(6)
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
SDFatigue ✓ ✓ ✓
SDInjection site rash ✓ ✓ ✓
SDRash pruritic ✓ ✓ ✓
SROFeeling abnormal ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SROPruritus ✓ ✓ ✓
SROUnevaluable event ✓ ✓ ✓

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

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