35M-23705-05069
3 vaccinations
4 coded responses
38 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 21-25
- ZIP prefix
- 130 / NY
- Registered
- 2021-01-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-11
Dose 1 — Moderna
-
2021-01-12
Registered in v-safe
-
2021-01-13
Survey response — days 1–6 daily, dose 1MedDRA: Lip swelling — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activitiesFree text: Left side of my top lip is swollenMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-13
Report sent to call center — days 1–6 daily, dose 1Be unable to work · Be unable to do your normal daily activities1 call case(s)
-
2021-01-14
Survey response — days 1–6 daily, dose 1MedDRA: COVID-19, Chills, Diarrhoea, Injection site pain, Lip swelling, Pyrexia — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: I was unable to report my side effects on 1.12.21 and 1.13.21. I had severe arm pain where the injection occurred. I developed a fever and chills ranging from 99.6 to 100.9 degrees Fahrenheit around 1 am on 1.12.21 along with moderate diarrhea.The left side of my top lip was also swollen. I also had COVID-19 within the past 90 days which is why I believe my side effects were severe. My side effects occurred for 48 hours and subsided on 1.14.21.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-25
- 2021-02-01
-
2021-02-08
Dose 2 — Moderna
- 2021-02-08
-
2021-02-09
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
- 2021-02-10
-
2021-02-11
Survey response — days 1–6 daily, dose 2MedDRA: Lip swelling — Feeling: Good · Headache, Joint painsFree text: Mild swelling of left side of bottom lipMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-12
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-22
- 2021-03-01
- 2021-03-08
- 2021-03-15
- 2021-03-22
- 2021-05-12
- 2021-08-09
-
2021-11-10
Dose 3 — Moderna
- 2021-11-11
- 2021-11-12
- 2021-11-13
- 2021-11-14
- 2021-11-15
- 2021-11-16
- 2021-11-17
- 2021-11-24
- 2021-12-01
- 2021-12-08
- 2021-12-15
- 2021-12-22
- 2022-02-09
-
2022-05-11
Survey response — 6 months, dose 3MedDRA: Cough, Eye pruritus, Fatigue, Lacrimation increased, Respiratory tract congestion, Rhinorrhoea — Feeling: Good · Be unable to work or attend schoolFree text: Congestion, runny nose, itchy/watery eyes, coughing, fatigueMedDRA releases: 2024-11 · check-in free text available
- 2022-11-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-11 | Moderna | |
| 2 | 2021-02-08 | Moderna | |
| 3 | 2021-11-10 | Moderna | No |
Call center
1 call center case
1 priority 2/3 (triaged and no follow up)
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Left side of my top lip is swollen
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): I was unable to report my side effects on 1.12.21 and 1.13.21. I had severe arm pain where the injection occurred. I developed a fever and chills ranging from 99.6 to 100.9 degrees Fahrenheit around 1 am on 1.12.21 along with moderate diarrhea.The left side of my top lip was also swollen. I also had COVID-19 within the past 90 days which is why I believe my side effects were severe. My side effects occurred for 48 hours and subsided on 1.14.21.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Mild swelling of left side of bottom lip
Release 11 — 6 months, dose 3
Symptoms: Congestion, runny nose, itchy/watery eyes, coughing, fatigue
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 | Cough | · | · | ✓ |
| SD | Eye pruritus | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Lacrimation increased | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | COVID-19 | ✓ | ✓ | ✓ |
| SRO | Diarrhoea | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Lip swelling | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release