342-18483-46734
4 vaccinations
4 coded responses
41 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 318 / GA
- Registered
- 2021-04-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-16
Registered in v-safe
-
2021-04-16
Dose 1 — Moderna
- 2021-04-16
- 2021-04-17
- 2021-04-18
- 2021-04-19
- 2021-04-20
- 2021-04-21
- 2021-04-22
- 2021-04-23
-
2021-04-30
Survey response — day 14, dose 1MedDRA: Pruritus, Rash — Feeling: GoodFree text: On evening of 7th day, experienced small rash patch with slight itchiness below injection sight. Remained for couple of days and faded away. No other problems or symptoms.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-07
-
2021-05-14
Dose 2 — Moderna
- 2021-05-14
- 2021-05-15
-
2021-05-16
Survey response — days 1–6 daily, dose 2MedDRA: Pain in extremity — Feeling: Good · Site: Redness, Itching · Muscle or body achesFree text: Injection arm ached a little last night, but OK today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-17
- 2021-05-18
- 2021-05-19
- 2021-05-20
- 2021-05-21
- 2021-05-28
- 2021-06-04
- 2021-06-11
- 2021-06-18
- 2021-06-25
- 2021-08-13
- 2021-11-12
-
2022-01-04
Dose 3 — Moderna
-
2022-05-16
Survey response — 12 months, dose 2MedDRA: Laboratory test abnormal, Night sweats, Paranasal sinus hypersecretion, Patient isolation — Feeling: GoodFree text: After experiencing couple of night sweats, sinus drippage beginning 1/6 or 7/2022, was tested 1/11/2022 with positive results. Isolated for 5 days, masked for 5 days. No further symptoms.MedDRA releases: 2024-11 · check-in free text available
-
2022-07-05
Dose 4 — Moderna
- 2022-07-05
-
2022-07-06
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Swelling, Itching · NoneAdult check-in
-
2022-07-07
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Swelling, Itching · NoneAdult check-in
- 2022-07-08
- 2022-07-09
- 2022-07-10
- 2022-07-11
- 2022-07-12
- 2022-07-19
- 2022-07-26
- 2022-08-02
- 2022-08-09
- 2022-08-16
- 2022-10-06
-
2023-01-04
Survey response — 6 months, dose 4MedDRA: Cystitis, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
-
2023-01-04
Report sent to call center — 6 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2023-01-05
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-16 | Moderna | |
| 2 | 2021-05-14 | Moderna | |
| 3 | 2022-01-04 | Moderna | No |
| 4 | 2022-07-05 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 8 — day 14, dose 1
Symptoms: On evening of 7th day, experienced small rash patch with slight itchiness below injection sight. Remained for couple of days and faded away. No other problems or symptoms.
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Injection arm ached a little last night, but OK today.
Release 11 — 12 months, dose 2
Symptoms: After experiencing couple of night sweats, sinus drippage beginning 1/6 or 7/2022, was tested 1/11/2022 with positive results. Isolated for 5 days, masked for 5 days. No further symptoms.
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 | Office visit | · | · | ✓ |
| SD | Cystitis | · | · | ✓ |
| SD | Laboratory test abnormal | · | · | ✓ |
| SD | Night sweats | · | · | ✓ |
| SD | Paranasal sinus hypersecretion | · | · | ✓ |
| SD | Patient isolation | · | · | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release