3GW-27725-37544
4 vaccinations
5 coded responses
26 check-ins
5 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 327 / FL
- Registered
- 2021-03-17
- Relationship
- Self
- Race
- White
- Ethnicity
- N/A
Registered dependents
UVY-92736-56114
Child or adolescent in my care · Male · 2022-06-30
Timeline
-
2021-03-12
Dose 1 — Moderna
-
2021-03-17
Registered in v-safe
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2021-03-17
Survey response — days 1–6 daily, dose 1MedDRA: Headache, Pain, Pain in extremity — Feeling: GoodFree text: The first day of shot, I got a bad headache that wouldnt go away. Arm sore and hard to move before bed. No other after effects days later.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-26
- 2021-04-04
-
2021-04-09
Dose 2 — Moderna
-
2021-04-10
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
-
2021-04-11
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pain, Injection site swelling — Feeling: Good · Site: Pain, Swelling · Muscle or body achesFree text: Injection site still pretty swollen and sore.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-12
Survey response — days 1–6 daily, dose 2MedDRA: Injection site swelling — Feeling: Good · Site: SwellingFree text: Injection site still swollen.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-13
Survey response — days 1–6 daily, dose 2MedDRA: Injection site swelling — Feeling: Good · Site: SwellingFree text: Only slight swelling at injection site. No pain. No redness.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-15
- 2021-04-16
- 2021-04-23
- 2021-05-21
- 2021-07-09
- 2021-10-08
-
2022-01-07
Dose 3 — Moderna
- 2022-04-11
-
2022-06-30
Dose 4 — ModernaCo-administered: Shingles
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2022-07-01
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
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2022-07-02
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Redness, Swelling · NoneAdult check-in
-
2022-07-03
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
- 2022-07-04
- 2022-07-05
- 2022-07-07
- 2022-07-14
- 2022-07-21
-
2022-07-28
Survey response — day 28, dose 4MedDRA: Extrasystoles, Impaired work ability, Palpitations, Pre-existing disease, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Had some heart palpitations for three days. My heart was skipping the down beat once in a while. I skipped work for two days. But I am obese, 53 and live a sedentary lifestyle. I tested negative for Covid.MedDRA releases: 2024-11 · check-in free text available
- 2022-08-04
- 2022-08-14
- 2022-09-29
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-12 | Moderna | |
| 2 | 2021-04-09 | Moderna | |
| 3 | 2022-01-07 | Moderna | No |
| 4 | 2022-06-30 | Moderna | Shingles |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): The first day of shot, I got a bad headache that wouldnt go away. Arm sore and hard to move before bed. No other after effects days later.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Injection site still pretty swollen and sore.
Systemic reaction (other): Injection site still swollen.
Systemic reaction (other): Only slight swelling at injection site. No pain. No redness.
Release 12 — day 28, dose 4
Symptoms: Had some heart palpitations for three days. My heart was skipping the down beat once in a while. I skipped work for two days. But I am obese, 53 and live a sedentary lifestyle. I tested negative for Covid.
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 | Extrasystoles | · | · | ✓ |
| SD | Impaired work ability | · | · | ✓ |
| SD | Palpitations | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site swelling | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release