36X-26710-52157
2 vaccinations
4 coded responses
24 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 871 / NM
- Registered
- 2021-01-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-27
Dose 1 — Moderna
-
2021-01-29
Registered in v-safe
-
2021-01-29
Survey response — days 1–6 daily, dose 1MedDRA: Asthma — Feeling: Good · Fatigue or tirednessFree text: A little more asthmaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-30
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Diarrhea · Be unable to do your normal daily activitiesAdult check-in
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-10
- 2021-02-17
-
2021-02-24
Dose 2 — Moderna
- 2021-02-24
- 2021-02-25
- 2021-02-26
-
2021-02-27
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: GoodFree text: Some asthma but not due to vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-03-31
- 2021-04-07
-
2021-05-26
Survey response — 3 months, dose 2MedDRA: Balance disorder, Ear disorder, Office visit, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Symptoms: Small growth in left ear, but still checking, and some balance problems. Might be related. Also my same old fatigue - but I dont think these are at all related to the vaccine (probably a touch of depression due to all the isolation during covid. · Healthcare visit (other): Then sent to an ENT for checking dealing with the ear. Regular inpatient visit.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-26
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-25
-
2022-02-14
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-02-24
Survey response — 12 months, dose 2MedDRA: Office visit, Tooth disorder — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Just dental work to be done · Healthcare visit (other): Dental officeMedDRA releases: 2024-11 · check-in free text available
-
2022-02-24
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2022-02-25
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-27 | Moderna | |
| 2 | 2021-02-24 | Moderna |
Call center
2 call center cases
2 successful
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): A little more asthma
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Some asthma but not due to vaccine
Release 8 — 3 months, dose 2
Symptoms: Small growth in left ear, but still checking, and some balance problems. Might be related. Also my same old fatigue - but I dont think these are at all related to the vaccine (probably a touch of depression due to all the isolation during covid.
Healthcare visit (other): Then sent to an ENT for checking dealing with the ear. Regular inpatient visit.
Release 11 — 12 months, dose 2
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 | ✓ | ✓ | ✓ |
| SD | Balance disorder | ✓ | ✓ | ✓ |
| SD | Ear disorder | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Tooth disorder | · | · | ✓ |
| SRO | Asthma | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release