3DT-28078-58206
2 vaccinations
5 coded responses
21 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 420 / KY
- Registered
- 2021-03-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-05
Registered in v-safe
-
2021-03-05
Dose 1 — Moderna
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-14
-
2021-04-02
Dose 2 — Moderna
-
2021-04-03
Survey response — days 1–6 daily, dose 2MedDRA: Adverse reaction — Feeling: Fair · Site: Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesFree text: This was all severe Thur night after I got the shot Thur afternoon I couldn't do anything Fri but the web site didn't let me in.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-05
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Itching · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-06
Survey response — days 1–6 daily, dose 2MedDRA: Adverse reaction — Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Today my roommate is feeling chills and nausea. He had his first covid 2 weeks ago so what I am experiencing my be another virus not the vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-07
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to workFree text: I believe we have gotten something else.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-08
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-09
- 2021-04-16
-
2021-04-23
Survey response — day 21, dose 2MedDRA: Fatigue, Nausea, Office visit — Feeling: Poor · Be unable to work, 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: Continued nausea and fatigue. It has been 3 wks and I'm still not able to function normally. I finally went to the doctor Thur.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-23
Report sent to call center — day 21, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-30
-
2021-05-08
Survey response — day 35, dose 2MedDRA: Aortic valve disease, Dyspnoea, Fatigue, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activitiesFree text: I waz diagnosed with a leaky Aorta valve 2 years ago. Since my covert shot I have experienced shortness of breath and fatigue that is worse than it waz before.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-14
- 2021-07-02
- 2021-10-03
-
2022-04-05
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-05 | Moderna | |
| 2 | 2021-04-02 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): This was all severe Thur night after I got the shot Thur afternoon I couldn't do anything Fri but the web site didn't let me in.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Today my roommate is feeling chills and nausea. He had his first covid 2 weeks ago so what I am experiencing my be another virus not the vaccine.
Systemic reaction (other): I believe we have gotten something else.
Release 7 — day 21, dose 2
Symptoms: Continued nausea and fatigue. It has been 3 wks and I'm still not able to function normally. I finally went to the doctor Thur.
Release 8 — day 35, dose 2
Symptoms: I waz diagnosed with a leaky Aorta valve 2 years ago. Since my covert shot I have experienced shortness of breath and fatigue that is worse than it waz before.
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 | Aortic valve disease | ○ | ✓ | ○ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Office visit | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | · | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release