36M-19129-40043
2 vaccinations
4 coded responses
16 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 21-25
- ZIP prefix
- 895 / NV
- Registered
- 2021-01-08
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-07
Dose 1 — Moderna
-
2021-01-08
Registered in v-safe
-
2021-01-10
Survey response — days 1–6 daily, dose 1MedDRA: Nasal congestion, Pre-existing disease, Self-medication — Feeling: Fair · Headache, Fatigue or tirednessFree text: Allergy like symptoms that do not clear up with allergy medication, mainly a stuffy noseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-11
Survey response — days 1–6 daily, dose 1MedDRA: Chest discomfort, Cough, Paranasal sinus discomfort — Feeling: Poor · Fever · Headache, Fatigue or tirednessFree text: Dry, airy cough, almost like an asthmatic cough, lots of sinus pressure, tight chestMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-12
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
- 2021-01-13
- 2021-01-15
- 2021-01-22
- 2021-01-28
-
2021-02-04
Dose 2 — Moderna
-
2021-02-11
Survey response — day 7, dose 2MedDRA: Chills, Headache, Movement disorder, Pain, Pyrexia — Feeling: Good · Site: PainFree text: February 5th i experienced body aches, chills, and a fever of 101.5. It was diffult to move or move out of bed. I also experienced a spinning headache and was very limited and had to lay flat for most of the weekend. The fever broke on the evening on February 5th. The headaches lasted until February 9thMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-18
- 2021-02-25
- 2021-03-06
- 2021-03-11
- 2021-03-18
- 2021-05-06
- 2021-08-05
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2022-02-06
Survey response — 12 months, dose 2MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Exacerbation of GERDMedDRA releases: 2024-11 · check-in free text available
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2022-02-06
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
- 2022-02-09
-
2022-02-14
Call successfulDoes not wish to fill out VAERS report
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-07 | Moderna | |
| 2 | 2021-02-04 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Allergy like symptoms that do not clear up with allergy medication, mainly a stuffy nose
Systemic reaction (other): Dry, airy cough, almost like an asthmatic cough, lots of sinus pressure, tight chest
Release 4 — day 7, dose 2
Systemic reaction (other): February 5th i experienced body aches, chills, and a fever of 101.5. It was diffult to move or move out of bed. I also experienced a spinning headache and was very limited and had to lay flat for most of the weekend. The fever broke on the evening on February 5th. The headaches lasted until February 9th
Release 11 — 12 months, dose 2
Symptoms: Exacerbation of GERD
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 | Condition aggravated | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SRO | Chest discomfort | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Hypersensitivity | ○ | ○ | ○ |
| SRO | Movement disorder | ✓ | ✓ | ✓ |
| SRO | Nasal congestion | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Paranasal sinus discomfort | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release