359-68416-29359
1 vaccination
3 coded responses
15 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 937 / CA
- Registered
- 2021-04-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-02
Registered in v-safe
-
2021-04-02
Dose 1 — Moderna
-
2021-04-02
Health check-in — day 0, dose 1Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-04-03
Survey response — days 1–6 daily, dose 1MedDRA: Loss of consciousness, Tongue biting — Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activitiesFree text: I bit my tongue last night, very badly, like when I've had epileptic seizures, totally unconcious. granMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
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2021-04-08
Survey response — days 1–6 daily, dose 1MedDRA: Cough, Vomiting — Feeling: Good · Nausea, Vomiting · Be unable to do your normal daily activitiesFree text: I do not know if my symptoms were related to coughing hard, which happens alot with me due to particles in the air, or to the Covid vax #1. This is the first time I've had vomit come up, in years, to clarify. Could be unrelated. I don't know. gMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-09
- 2021-04-16
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-07-02
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2021-10-02
Survey response — 6 months, dose 1MedDRA: Cholelithotomy, Gallbladder operation — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Symptoms: Gall bladder surgery 3 days ago. Gall stones surgery in a tube 6 days ago. · Healthcare visit (other): Gall bladder surgery.MedDRA releases: 2024-11 · check-in free text available
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2021-10-02
Report sent to call center — 6 months, dose 1Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2021-10-04
- 2022-04-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-02 | Moderna |
Call center
1 call center case
1 unsuccessful
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): I bit my tongue last night, very badly, like when I've had epileptic seizures, totally unconcious. gran
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): I do not know if my symptoms were related to coughing hard, which happens alot with me due to particles in the air, or to the Covid vax #1. This is the first time I've had vomit come up, in years, to clarify. Could be unrelated. I don't know. g
Release 9 — 6 months, dose 1
Symptoms: Gall bladder surgery 3 days ago. Gall stones surgery in a tube 6 days ago.
Healthcare visit (other): Gall bladder surgery.
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 | Gallbladder operation | · | · | ✓ |
| SD | Cholelithotomy | · | · | ✓ |
| SD | Gallbladder operation | · | · | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
| SRO | Loss of consciousness | ✓ | ✓ | ✓ |
| SRO | Tongue biting | ✓ | ✓ | ✓ |
| SRO | Vomiting | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release