3ER-31536-51075
5 vaccinations
10 coded responses
49 check-ins
9 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 301 / GA
- Registered
- 2021-02-03
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-03
Registered in v-safe
-
2021-02-03
Dose 1 — Moderna
- 2021-02-03
-
2021-02-04
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: GoodFree text: Soreness at injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-05
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-17
- 2021-02-24
-
2021-03-03
Dose 2 — Moderna
- 2021-03-03
-
2021-03-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Itching · Fatigue or tirednessAdult check-in
-
2021-03-05
Survey response — days 1–6 daily, dose 2MedDRA: Headache — Feeling: Good · Site: Pain, Itching · Fever · Fatigue or tirednessFree text: Slight headache occasionallyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Itching · Fever · Headache, Fatigue or tirednessAdult check-in
-
2021-03-07
Survey response — days 1–6 daily, dose 2MedDRA: Gingival pain, Glossodynia, Oral pain — Feeling: Good · Site: Itching · Headache, Fatigue or tirednessFree text: Pain in mouthgums and tongueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-08
Survey response — days 1–6 daily, dose 2MedDRA: Gingival pain — Feeling: GoodFree text: Soreness in the back gums in my mouthMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-09
Survey response — days 1–6 daily, dose 2MedDRA: Gingival pain — Feeling: GoodFree text: Soreness in bottom back gums in mouthMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-10
Survey response — day 7, dose 2MedDRA: Oropharyngeal pain — Feeling: GoodFree text: Sore throatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-17
- 2021-03-24
- 2021-03-31
- 2021-04-07
- 2021-04-14
- 2021-06-02
- 2021-09-01
-
2021-10-27
Dose 3 — Moderna
- 2022-03-03
-
2022-05-03
Dose 4 — Moderna
-
2022-05-04
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Swelling · Fatigue or tiredness, DiarrheaAdult check-in
- 2022-05-05
-
2022-05-06
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Swelling · Muscle or body achesAdult check-in
- 2022-05-07
- 2022-05-08
- 2022-05-09
- 2022-05-10
- 2022-05-17
-
2022-05-24
Survey response — day 21, dose 4MedDRA: Breast cancer, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: I received a breast cancer diagnosis yesterday. · Healthcare visit (other): I had a 2 ultrasounds, 1 biopsy, and a mammogram as an outpatient.MedDRA releases: 2024-11 · check-in free text available
-
2022-05-24
Report sent to call center — day 21, dose 4Get care from a doctor or other healthcare professional1 call case(s)
-
2022-05-25
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-05-31
Survey response — day 28, dose 4MedDRA: Nasal congestion, Nasopharyngitis, Respiratory tract congestion, Self-medication — Feeling: GoodFree text: Nasal and chest congestion as if I have a cold. I have been taking Coricidin HBP chest congestion and cough softgels and Tylenol extra strength. My temperature has remained normal.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-07
- 2022-06-14
-
2022-08-02
Survey response — 3 months, dose 4MedDRA: Cancer surgery, Fungal infection — Feeling: Good · Get care from a doctor or other healthcare professional · HospitalizationFree text: Had breast cancer surgery on 07/15/2022. Being treated now for a fungus that appeared under my breasts.MedDRA releases: 2024-11 · check-in free text available
-
2022-08-02
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professionalHospitalization · 1 call case(s)
-
2022-08-03
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-10-12
Dose 5 — ModernaCo-administered: Flu
- 2022-10-17
- 2022-10-18
- 2022-10-19
- 2022-10-26
- 2022-11-02
- 2022-11-09
- 2022-11-16
- 2022-11-23
- 2023-01-11
-
2023-04-12
Survey response — 6 months, dose 5MedDRA: Carpal tunnel decompression, Deafness unilateral, Limb operation, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
-
2023-04-12
Report sent to call center — 6 months, dose 5Get care from a doctor or other healthcare professional1 call case(s)
-
2023-04-13
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-03 | Moderna | |
| 2 | 2021-03-03 | Moderna | |
| 3 | 2021-10-27 | Moderna | No |
| 4 | 2022-05-03 | Moderna | No |
| 5 | 2022-10-12 | Moderna | Flu |
Call center
3 call center cases
3 successful
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Soreness at injection site
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Slight headache occasionally
Systemic reaction (other): Pain in mouthgums and tongue
Systemic reaction (other): Soreness in the back gums in my mouth
Systemic reaction (other): Soreness in bottom back gums in mouth
Release 5 — day 7, dose 2
Systemic reaction (other): Sore throat
Release 11 — day 21, dose 4
Symptoms: I received a breast cancer diagnosis yesterday.
Healthcare visit (other): I had a 2 ultrasounds, 1 biopsy, and a mammogram as an outpatient.
Release 11 — day 28, dose 4
Symptoms: Nasal and chest congestion as if I have a cold. I have been taking Coricidin HBP chest congestion and cough softgels and Tylenol extra strength. My temperature has remained normal.
Release 12 — 3 months, dose 4
Symptoms: Had breast cancer surgery on 07/15/2022. Being treated now for a fungus that appeared under my breasts.
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 | Limb operation | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Breast cancer | · | · | ✓ |
| SD | Cancer surgery | · | · | ✓ |
| SD | Carpal tunnel decompression | · | · | ✓ |
| SD | Deafness unilateral | · | · | ✓ |
| SD | Fungal infection | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SRO | Gingival pain | ✓ | ✓ | ✓ |
| SRO | Glossodynia | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Oral pain | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release