3BT-23677-63756
5 vaccinations
10 coded responses
58 check-ins
9 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 921 / CA
- Registered
- 2021-02-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-05
Registered in v-safe
-
2021-02-05
Dose 1 — Moderna
- 2021-02-05
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-12
- 2021-02-19
- 2021-02-26
- 2021-03-07
-
2021-03-08
Dose 2 — Moderna
- 2021-03-08
-
2021-03-09
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-10
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Itching · Fatigue or tirednessAdult check-in
- 2021-03-11
- 2021-03-12
- 2021-03-13
-
2021-03-14
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Epistaxis, Hyperhidrosis — Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: I was shivering with chills. Later I was drenched in sweat. It might be coincidental, but I had 3 nosebleeds this week (could be due to the dry winter air, though).MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-15
Survey response — day 7, dose 2MedDRA: Insomnia — Feeling: Good · Fatigue or tirednessFree text: Insomnia. Awake 3 hours after going to sleep without falling back asleepMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-22
- 2021-03-29
- 2021-04-05
- 2021-04-12
- 2021-04-19
- 2021-06-07
- 2021-09-06
-
2021-10-22
Dose 3 — Moderna
-
2021-10-25
Survey response — days 1–6 daily, dose 3MedDRA: Oropharyngeal pain, Sinus congestion — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Sinus congestion and sore throatMedDRA releases: 2024-11 · check-in free text available
-
2021-10-26
Survey response — days 1–6 daily, dose 3MedDRA: Oropharyngeal pain, Rhinorrhoea, Sinus congestion — Feeling: Poor · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Sinus congestion, runny nose and sore throatMedDRA releases: 2024-11 · check-in free text available
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2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: Oropharyngeal pain, Rhinorrhoea, Sinus congestion, Tinnitus — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Sinus congestion, dripping nose, sore throat and ringing in earsMedDRA releases: 2024-11 · check-in free text available
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2021-10-28
Survey response — days 1–6 daily, dose 3MedDRA: Sinus congestion — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Sinus congestionMedDRA releases: 2024-11 · check-in free text available
-
2021-10-29
Health check-in — day 7, dose 3Feeling: Fair · Headache, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activitiesAdult check-in
- 2021-11-05
- 2021-11-13
- 2021-11-19
- 2021-11-26
- 2021-12-05
- 2022-01-21
-
2022-04-22
Dose 4 — Moderna
- 2022-04-22
- 2022-05-14
- 2022-05-20
- 2022-05-27
- 2022-06-03
- 2022-07-22
-
2022-09-27
Dose 5 — Moderna
- 2022-09-27
-
2022-09-28
Survey response — days 1–6 daily, dose 5MedDRA: Irritability — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: IrritabilityMedDRA releases: 2024-11 · check-in free text available
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2022-09-29
Survey response — days 1–6 daily, dose 5MedDRA: Insomnia — Feeling: Fair · Site: Pain · Fatigue or tirednessFree text: Insomnia last nightMedDRA releases: 2024-11 · check-in free text available
- 2022-09-30
- 2022-10-01
- 2022-10-02
- 2022-10-03
- 2022-10-04
- 2022-10-11
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2022-10-18
Survey response — day 21, dose 5MedDRA: COVID-19 — Feeling: Poor · 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 visitFree text: CovidMedDRA releases: 2024-11 · check-in free text available
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2022-10-18
Report sent to call center — day 21, dose 5Be 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 · 1 call case(s)
- 2022-10-19
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2022-10-19
Call successfulDoes not wish to fill out VAERS report
- 2022-10-25
- 2022-11-01
- 2022-11-08
- 2022-12-27
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2023-03-28
Survey response — 6 months, dose 5MedDRA: Cough, Respiratory tract infection viral, Rhinorrhoea — Feeling: Poor · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-05 | Moderna | |
| 2 | 2021-03-08 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
| 4 | 2022-04-22 | Moderna | No |
| 5 | 2022-09-27 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): I was shivering with chills. Later I was drenched in sweat. It might be coincidental, but I had 3 nosebleeds this week (could be due to the dry winter air, though).
Release 5 — day 7, dose 2
Systemic reaction (other): Insomnia. Awake 3 hours after going to sleep without falling back asleep
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Sinus congestion and sore throat
Systemic reaction (other): Sinus congestion, runny nose and sore throat
Systemic reaction (other): Sinus congestion, dripping nose, sore throat and ringing in ears
Systemic reaction (other): Sinus congestion
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Irritability
Systemic reaction (other): Insomnia last night
Release 12 — day 21, dose 5
Symptoms: Covid
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 | COVID-19 | · | · | ✓ |
| SD | Respiratory tract infection viral | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Epistaxis | ✓ | ✓ | ✓ |
| SRO | Hyperhidrosis | ✓ | ✓ | ✓ |
| SRO | Insomnia | ✓ | ✓ | ✓ |
| SRO | Irritability | · | · | ✓ |
| SRO | Oropharyngeal pain | · | · | ✓ |
| SRO | Rhinorrhoea | · | · | ✓ |
| SRO | Sinus congestion | · | · | ✓ |
| SRO | Tinnitus | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release