3D4-19816-89090
1 vaccination
4 coded responses
6 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 913 / CA
- Registered
- 2021-01-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-01-05
Dose 1 — Moderna
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2021-01-11
Registered in v-safe
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2021-01-19
Survey response — day 14, dose 1MedDRA: Facial pain, Fatigue, Headache, Oropharyngeal pain, SARS-CoV-2 test negative — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Extreme fatigue, sore throat, headaches and face pain I did get tested twice for Covid for work and both times it was negative including a rapid test today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-26
Survey response — day 21, dose 1MedDRA: Deafness transitory, Deafness unilateral, Fatigue, Headache, Hypoaesthesia, Medical counselling — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Severe headaches and face numbness on left side. Bit my lip and cheek while eating a lot. I had brief loss of hearing on left side last week but then came back after a minute or so. Still very fatigued. MD rxd Prednisone to help with SXMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-26
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-02-06
Survey response — day 28, dose 1MedDRA: Fatigue, Headache, Hypoaesthesia, Hypoaesthesia oral, Medical counselling — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Severe headache and fatigue, Left side of cheek and lip numbness · Healthcare visit (other): MRIMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-06
Report sent to call center — day 28, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-11
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2021-02-21
Survey response — day 42, dose 1MedDRA: Headache, Nausea, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Continued headache and nausea · Healthcare visit (other): MRIMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-21
Report sent to call center — day 42, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-08
- 2021-04-09
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-05 | Moderna |
Call center
3 call center cases
3 unsuccessful
Free text
Release 2 — day 14, dose 1
Symptoms: Extreme fatigue, sore throat, headaches and face pain I did get tested twice for Covid for work and both times it was negative including a rapid test today.
Release 2 — day 21, dose 1
Symptoms: Severe headaches and face numbness on left side. Bit my lip and cheek while eating a lot. I had brief loss of hearing on left side last week but then came back after a minute or so. Still very fatigued. MD rxd Prednisone to help with SX
Release 3 — day 28, dose 1
Symptoms: Severe headache and fatigue, Left side of cheek and lip numbness
Healthcare visit (other): MRI
Release 4 — day 42, dose 1
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 | Medical counselling | ✓ | ✓ | ✓ |
| HCVO | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Deafness transitory | ✓ | ✓ | ✓ |
| SD | Deafness unilateral | ✓ | ✓ | ✓ |
| SD | Facial pain | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Hypoaesthesia | ✓ | ✓ | ✓ |
| SD | Hypoaesthesia oral | ✓ | ✓ | ✓ |
| SD | Medical counselling | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release