347-16253-73671
2 vaccinations
5 coded responses
19 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 300 / GA
- Registered
- 2021-02-19
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-11
Dose 1 — Moderna
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2021-02-19
Registered in v-safe
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2021-02-19
Survey response — day 7, dose 1MedDRA: Pyrexia — Feeling: Good · Site: PainFree text: I had a slight fever from 2/11 to 2/14MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-25
- 2021-03-04
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2021-03-11
Dose 2 — Moderna
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2021-03-11
Survey response — day 0, dose 2MedDRA: Unevaluable event — Feeling: GoodFree text: I received the vaccine 2 hrs ago so no symptoms.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-12
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness, Injection site pain, Injection site warmth, Oropharyngeal pain, Pain — Feeling: Poor · Site: Pain · Fever · Muscle or body aches, Fatigue or tirednessFree text: Pain at injection site and quite warm to the touch. A bit of sore throat and some body ache I also feel a bit woozy/dizzy.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-13
Survey response — days 1–6 daily, dose 2MedDRA: Body temperature increased, Pyrexia, Self-medication — Feeling: Fair · Site: Pain, Itching · Fever · Muscle or body aches · Be unable to do your normal daily activitiesFree text: My temp went up to 100.4 last night. I took tylenol which helped. A low grade fever returnef today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-25
- 2021-04-01
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2021-04-09
Survey response — day 28, dose 2MedDRA: Hospitalisation, Loss of consciousness, Syncope — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Symptoms: Passed out on Sunday. Taken to (b)(6) and the diagnosis was Vasovagal Syncope. · Healthcare visit (other): Was kept in hospital overnight and released mid-day.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-09
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-16
- 2021-04-22
- 2021-06-10
- 2021-09-09
- 2021-11-06
- 2022-03-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-11 | Moderna | |
| 2 | 2021-03-11 | Moderna |
Call center
1 call center case
1 unsuccessful
1 wait over 3 months for a first call
Free text
Release 4 — day 7, dose 1
Systemic reaction (other): I had a slight fever from 2/11 to 2/14
Release 5 — day 0, dose 2
Systemic reaction (other): I received the vaccine 2 hrs ago so no symptoms.
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Pain at injection site and quite warm to the touch. A bit of sore throat and some body ache I also feel a bit woozy/dizzy.
Systemic reaction (other): My temp went up to 100.4 last night. I took tylenol which helped. A low grade fever returnef today.
Release 7 — day 28, dose 2
Symptoms: Passed out on Sunday. Taken to (b)(6) and the diagnosis was Vasovagal Syncope.
Healthcare visit (other): Was kept in hospital overnight and released mid-day.
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Hospitalisation | ✓ | ✓ | ✓ |
| SD | Hospitalisation | ✓ | ✓ | ✓ |
| SD | Loss of consciousness | ✓ | ✓ | ✓ |
| SD | Syncope | ✓ | ✓ | ✓ |
| SRO | Body temperature increased | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site warmth | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release