3DJ-30461-93845
5 vaccinations
7 coded responses
66 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 836 / ID
- Registered
- 2021-02-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-10
Registered in v-safe
-
2021-02-10
Dose 1 — Moderna
- 2021-02-10
-
2021-02-11
Survey response — days 1–6 daily, dose 1MedDRA: Insomnia — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Insomnia till very early in the morningMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-12
- 2021-02-13
-
2021-02-14
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-02-15
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-02-16
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-17
- 2021-02-24
- 2021-03-03
-
2021-03-10
Dose 2 — Moderna
- 2021-03-10
-
2021-03-11
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-13
-
2021-03-14
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Diarrhea, Abdominal painAdult check-in
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-24
- 2021-03-31
- 2021-04-07
- 2021-04-14
- 2021-04-21
- 2021-06-09
- 2021-09-08
-
2021-11-01
Dose 3 — Moderna
- 2021-11-01
-
2021-11-02
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Muscle or body aches, DiarrheaAdult check-in
-
2021-11-03
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
-
2021-11-04
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Headache, DiarrheaAdult check-in
- 2021-11-05
- 2021-11-06
- 2021-11-07
- 2021-11-08
- 2021-11-17
- 2021-11-22
- 2021-11-29
- 2021-12-06
-
2021-12-14
Survey response — day 42, dose 3MedDRA: Back pain, Flank pain, Muscular weakness — Feeling: Fair · 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: Lower back pain, weakness in the legs and side pain at the waistline on the left side.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-14
Report sent to call center — day 42, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-12-15
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-01-31
-
2022-04-22
Dose 4 — ModernaCo-administered: Flu
-
2022-04-23
Survey response — days 1–6 daily, dose 4MedDRA: Injection site pain — Feeling: Fair · Site: Pain, Swelling · Muscle or body achesFree text: Mild to moderate pain in the arm at injection siteMedDRA releases: 2024-11 · check-in free text available
- 2022-04-24
- 2022-04-25
- 2022-04-26
-
2022-04-27
Survey response — days 1–6 daily, dose 4MedDRA: No adverse event — Feeling: Good · Joint pains, Muscle or body achesFree text: NoMedDRA releases: 2024-11 · check-in free text available
- 2022-04-28
- 2022-04-29
-
2022-05-06
Survey response — day 14, dose 4MedDRA: Back pain — Feeling: Fair · Be unable to work or attend schoolFree text: Back pain for 4 days.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-13
- 2022-05-20
- 2022-05-27
- 2022-06-03
-
2022-07-22
Survey response — 3 months, dose 4MedDRA: Cough, Pre-existing disease, Rhinorrhoea — Feeling: GoodFree text: Cough and runny nose. I tested negative and the following day had no similar symptoms. I also have allergies and attributed those stmt to my allergies after the negative test.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-18
Dose 5 — Pfizer-BioNTech
- 2022-10-18
- 2022-10-19
- 2022-10-20
- 2022-10-21
-
2022-10-22
Health check-in — days 1–6 daily, dose 5Feeling: Good · Headache, Joint pains, Muscle or body achesAdult check-in
- 2022-10-23
- 2022-10-24
- 2022-10-27
- 2022-11-01
- 2022-11-08
- 2022-11-15
- 2022-11-22
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2022-11-29
Survey response — day 42, dose 5MedDRA: Cough, Nasopharyngitis, Respiratory tract congestion, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activitiesFree text: I fought a cold with a cough. I tested twice in the past 2 weeks to be sure it wasn't COVID with negative results both times. Head cold with mild congestion and cough that seems to be improving daily with rest and hydration. I stayed home.MedDRA releases: 2024-11 · check-in free text available
- 2023-01-17
- 2023-04-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-10 | Moderna | |
| 2 | 2021-03-10 | Moderna | |
| 3 | 2021-11-01 | Moderna | No |
| 4 | 2022-04-22 | Moderna | Flu |
| 5 | 2022-10-18 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Insomnia till very early in the morning
Release 10 — day 42, dose 3
Symptoms: Lower back pain, weakness in the legs and side pain at the waistline on the left side.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Mild to moderate pain in the arm at injection site
Systemic reaction (other): No
Release 11 — day 14, dose 4
Symptoms: Back pain for 4 days.
Release 12 — 3 months, dose 4
Symptoms: Cough and runny nose. I tested negative and the following day had no similar symptoms. I also have allergies and attributed those stmt to my allergies after the negative test.
Release 12 — day 42, dose 5
Symptoms: I fought a cold with a cough. I tested twice in the past 2 weeks to be sure it wasn't COVID with negative results both times. Head cold with mild congestion and cough that seems to be improving daily with rest and hydration. I stayed home.
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 | Back pain | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Flank pain | · | · | ✓ |
| SD | Muscular weakness | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Insomnia | ✓ | ✓ | ✓ |
| SRO | No adverse event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release