3BZ-10293-38322
4 vaccinations
5 coded responses
16 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 863 / AZ
- Registered
- 2022-05-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-03
Dose 1 — Moderna
-
2021-03-03
Dose 2 — Moderna
-
2021-11-05
Dose 3 — Moderna
-
2022-05-20
Registered in v-safe
-
2022-05-20
Dose 4 — Moderna
-
2022-05-20
Health check-in — day 0, dose 4Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2022-05-21
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
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2022-05-22
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2022-05-23
Survey response — days 1–6 daily, dose 4MedDRA: Depression — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: DepressionMedDRA releases: 2024-11 · check-in free text available
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2022-05-24
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Redness · Fatigue or tirednessAdult check-in
- 2022-05-25
- 2022-05-26
- 2022-05-27
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2022-06-03
Survey response — day 14, dose 4MedDRA: Unevaluable event — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Systemic allergic reaction, probably triggered by digestive enzyne supplement (?). Burning, itchy hives over large areas of my skin.MedDRA releases: 2024-11 · check-in free text available
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2022-06-10
Survey response — day 21, dose 4MedDRA: Hypersensitivity, Migraine, Urticaria — Feeling: Fair · Be unable to do your normal daily activitiesFree text: 7 days of systemic allergic reaction/hives, no known trigger, followed by a migraine that lasted 4 daysMedDRA releases: 2024-11 · check-in free text available
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2022-06-17
Survey response — day 28, dose 4MedDRA: Headache — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Severe headachesMedDRA releases: 2024-11 · check-in free text available
- 2022-06-24
- 2022-07-01
- 2022-08-19
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2022-11-18
Survey response — 6 months, dose 4MedDRA: COVID-19, Cough, Malaise, Mobility decreased, Unevaluable event — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: I got COVID and was very sick (in bed) for 2 weeks and sick for another 2 weeks after that. Cough lingered after that. · Healthcare visit (other): My spouse called my primary care NP's office for me.MedDRA releases: 2024-11 · check-in free text available
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2022-11-18
Report sent to call center — 6 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
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2022-11-21
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2023-05-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-03 | Moderna | No |
| 2 | 2021-03-03 | Moderna | No |
| 3 | 2021-11-05 | Moderna | No |
| 4 | 2022-05-20 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Depression
Release 11 — day 14, dose 4
Symptoms: Systemic allergic reaction, probably triggered by digestive enzyne supplement (?). Burning, itchy hives over large areas of my skin.
Release 12 — day 21, dose 4
Symptoms: 7 days of systemic allergic reaction/hives, no known trigger, followed by a migraine that lasted 4 days
Release 12 — day 28, dose 4
Symptoms: Severe headaches
Release 12 — 6 months, dose 4
Symptoms: I got COVID and was very sick (in bed) for 2 weeks and sick for another 2 weeks after that. Cough lingered after that.
Healthcare visit (other): My spouse called my primary care NP's office for me.
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 | Unevaluable event | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Hypersensitivity | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Migraine | · | · | ✓ |
| SD | Mobility decreased | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
| SRO | Depression | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release