375-20314-22665
4 vaccinations
3 coded responses
38 check-ins
2 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 930 / CA
- Registered
- 2021-01-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
ZP4-27577-60731
Child or adolescent in my care · Male · 2022-06-22
F5M-27732-47589
Child or adolescent in my care · Male · 2022-06-22
Timeline
-
2021-01-02
Registered in v-safe
-
2021-01-02
Dose 1 — Moderna
- 2021-01-02
- 2021-01-03
-
2021-01-04
Survey response — days 1–6 daily, dose 1MedDRA: Abdominal pain — Feeling: GoodFree text: Mild lower abdominal crampingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-06
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-16
- 2021-01-23
-
2021-01-28
Dose 2 — Moderna
-
2021-01-30
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Headache, Pain, Pyrexia — Feeling: Good · Site: Pain · HeadacheFree text: Mild headache today. The day after my vaccine (1/29) developed chills and body aches about 12 hours post vaccination and this progressed to a mild fever of 100.4 which broke easily with Tylenol. I was feeling back to normal by 26 hours post vaccine and the symptom onset was approximately 15 hours post vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-11
- 2021-02-18
- 2021-02-25
- 2021-03-04
- 2021-03-11
- 2021-04-29
- 2021-07-29
-
2021-11-19
Dose 3 — Moderna
- 2022-01-28
- 2022-02-20
- 2022-05-20
-
2022-09-04
Dose 4 — Moderna
- 2022-09-04
-
2022-09-05
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-09-08
- 2022-09-09
- 2022-09-10
- 2022-09-11
- 2022-09-19
- 2022-09-25
- 2022-10-02
- 2022-10-09
- 2022-10-18
- 2022-12-04
- 2023-03-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-02 | Moderna | |
| 2 | 2021-01-28 | Moderna | |
| 3 | 2021-11-19 | Moderna | No |
| 4 | 2022-09-04 | Moderna | No |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Mild lower abdominal cramping
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Mild headache today. The day after my vaccine (1/29) developed chills and body aches about 12 hours post vaccination and this progressed to a mild fever of 100.4 which broke easily with Tylenol. I was feeling back to normal by 26 hours post vaccine and the symptom onset was approximately 15 hours post vaccine.
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 | Vision blurred | · | · | ✓ |
| SRO | Abdominal discomfort | ○ | ○ | ○ |
| SRO | Abdominal pain | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Muscle spasms | ○ | ○ | ○ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release