363-17177-32685
2 vaccinations
4 coded responses
20 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 106 / NY
- Registered
- 2021-03-02
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-02
Registered in v-safe
-
2021-03-02
Dose 1 — Moderna
- 2021-03-02
- 2021-03-03
-
2021-03-05
Survey response — days 1–6 daily, dose 1MedDRA: Musculoskeletal stiffness, Neck pain — Feeling: Good · Site: PainFree text: Mild pain and stiffness the back of the neck.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-06
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: Fair · HeadacheFree text: One episode of light headedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-16
- 2021-03-23
- 2021-03-30
-
2021-03-31
Dose 2 — Moderna
-
2021-04-06
Survey response — days 1–6 daily, dose 2MedDRA: Abdominal pain, Chills, Cold sweat, Condition aggravated, Diarrhoea, Pre-existing disease — Feeling: Good · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesFree text: I had pre-exsisted condition of sevious abdominal pain and diarrhea with cold sweat once every few months. It happened on the next day I received the vaccine plus chill during and after. Usually, if I had an episode, it only happened once, then wouldnt happen again till another 2to3 months. However, this this time it happened in 2 days in a roll.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-07
- 2021-04-15
- 2021-04-21
- 2021-04-29
- 2021-05-06
-
2021-05-12
Survey response — day 42, dose 2MedDRA: Adverse reaction, Office visit, SARS-CoV-2 test positive — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: After Mother's day lunch. Later symptoms similar to after 2nd vaccine occurred. 2nd vaccine done on 3/31. Side effect occurred next day, last for a few days. Not sure why symptoms returned. · Healthcare visit (other): Saw primary doctor, tested for covid 19, still waiting for the result.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-12
Report sent to call center — day 42, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-30
- 2021-10-01
- 2022-04-02
- 2022-05-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-02 | Moderna | |
| 2 | 2021-03-31 | Moderna |
Call center
1 call center case
1 unsuccessful
1 wait over 3 months for a first call
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Mild pain and stiffness the back of the neck.
Systemic reaction (other): One episode of light headed
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): I had pre-exsisted condition of sevious abdominal pain and diarrhea with cold sweat once every few months. It happened on the next day I received the vaccine plus chill during and after. Usually, if I had an episode, it only happened once, then wouldnt happen again till another 2to3 months. However, this this time it happened in 2 days in a roll.
Release 8 — day 42, dose 2
Symptoms: After Mother's day lunch. Later symptoms similar to after 2nd vaccine occurred. 2nd vaccine done on 3/31. Side effect occurred next day, last for a few days. Not sure why symptoms returned.
Healthcare visit (other): Saw primary doctor, tested for covid 19, still waiting for the result.
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 | ✓ | ✓ | ✓ |
| HCVO | SARS-CoV-2 test positive | ✓ | ✓ | ✓ |
| SD | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Abdominal pain | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Cold sweat | ✓ | · | ✓ |
| SRO | Condition aggravated | ✓ | · | ✓ |
| SRO | Diarrhoea | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Musculoskeletal stiffness | ✓ | ✓ | ✓ |
| SRO | Neck pain | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release