3D6-23941-60146
2 vaccinations
5 coded responses
25 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 604 / IL
- Registered
- 2021-03-17
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-17
Registered in v-safe
-
2021-03-17
Dose 1 — Moderna
- 2021-03-17
-
2021-03-18
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-03-19
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body achesAdult check-in
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-31
- 2021-04-07
- 2021-04-14
-
2021-04-15
Dose 2 — Moderna
- 2021-04-16
-
2021-04-17
Survey response — days 1–6 daily, dose 2MedDRA: Restlessness — Feeling: Good · Fatigue or tirednessFree text: Restlessness.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-19
- 2021-04-20
- 2021-04-21
- 2021-04-22
- 2021-04-29
- 2021-05-06
-
2021-05-13
Survey response — day 28, dose 2MedDRA: Somnolence — Feeling: FairFree text: I still seem sleepy very difficult to get out of bed as early as I normally would. I feel like this is better than after my second shot but still concerning.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-20
- 2021-05-27
-
2021-07-15
Survey response — 3 months, dose 2MedDRA: Emergency care, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activitiesFree text: My right leg at my right outside calf muscle has landed me in emergency twice.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-10-14
Survey response — 6 months, dose 2MedDRA: Gait disturbance, Pain in extremity — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: I had a problem with my right leg calf area, couldn't hardly walk. Much better now and no issues.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-14
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
- 2021-10-18
-
2021-10-18
Call successfulDoes not wish to fill out VAERS report
-
2022-04-15
Survey response — 12 months, dose 2MedDRA: COVID-19 — Feeling: Good · Be unable to do your normal daily activitiesFree text: I did contact covid 19 exactly a week after receiving my booster shot.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-17 | Moderna | |
| 2 | 2021-04-15 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Restlessness.
Release 8 — day 28, dose 2
Symptoms: I still seem sleepy very difficult to get out of bed as early as I normally would. I feel like this is better than after my second shot but still concerning.
Release 9 — 3 months, dose 2
Symptoms: My right leg at my right outside calf muscle has landed me in emergency twice.
Release 10 — 6 months, dose 2
Symptoms: I had a problem with my right leg calf area, couldn't hardly walk. Much better now and no issues.
Release 11 — 12 months, dose 2
Symptoms: I did contact covid 19 exactly a week after receiving my booster shot.
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 | COVID-19 | · | · | ✓ |
| SD | Emergency care | ✓ | · | ✓ |
| SD | Gait disturbance | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Somnolence | ✓ | ✓ | ✓ |
| SD | Unevaluable event | ✓ | · | ✓ |
| SRO | Restlessness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release