3J6-39167-15430
3 vaccinations
7 coded responses
25 check-ins
7 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 472 / IN
- Registered
- 2021-02-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-02-19
Dose 1 — Moderna
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2021-02-20
Registered in v-safe
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2021-02-20
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain, Itching · Chills, Headache, Fatigue or tiredness, Nausea, Vomiting · Be unable to workAdult check-in
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2021-02-21
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Itching · Fatigue or tirednessAdult check-in
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2021-02-22
Survey response — days 1–6 daily, dose 1MedDRA: Tinnitus — Feeling: Fair · Site: Pain · Fatigue or tirednessFree text: Buzzing sound in the right ear.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-24
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain, Tinnitus — Feeling: Good · Site: Pain · Muscle or body achesFree text: Buzzing in right ear is still happening. Little pain is still present at injection site in the muscle. (Bruised feeling)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-25
- 2021-02-26
- 2021-03-05
- 2021-03-12
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2021-03-19
Dose 2 — Moderna
- 2021-03-19
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2021-03-20
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-03-21
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness, NauseaAdult check-in
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2021-03-22
Survey response — days 1–6 daily, dose 2MedDRA: Cough, Fatigue, Rhinorrhoea — Feeling: Fair · Site: PainFree text: Fatigue, Runny nose and Cough.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-23
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue, Rhinorrhoea — Feeling: FairFree text: Fatigue, Runny NoseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-25
- 2021-03-26
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2021-04-02
Survey response — day 14, dose 2MedDRA: Cough, Facial discomfort, Rhinorrhoea, Tongue discomfort — Feeling: FairFree text: Right side tongue and cheek symptoms have returned, runny nose and a cough.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-09
- 2021-04-16
- 2021-04-23
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2021-05-02
Survey response — day 42, dose 2MedDRA: Chills, Headache, Malaise, Oropharyngeal pain, Rhinorrhoea — Feeling: Poor · Be unable to workFree text: Sore throat, runny nose, malaise, chills and a mild headache.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-18
- 2021-09-19
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2021-11-12
Dose 3 — Moderna
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2022-03-19
Survey response — 12 months, dose 2MedDRA: Discomfort, Hypoacusis, Rhinorrhoea — Feeling: FairFree text: Ongoing nasal drainage and feeling pressure and having hearing issues with both ears.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-13
- 2022-11-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-19 | Moderna | |
| 2 | 2021-03-19 | Moderna | |
| 3 | 2021-11-12 | Moderna | No |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Buzzing sound in the right ear.
Systemic reaction (other): Buzzing in right ear is still happening. Little pain is still present at injection site in the muscle. (Bruised feeling)
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Fatigue, Runny nose and Cough.
Systemic reaction (other): Fatigue, Runny Nose
Release 6 — day 14, dose 2
Symptoms: Right side tongue and cheek symptoms have returned, runny nose and a cough.
Release 8 — day 42, dose 2
Symptoms: Sore throat, runny nose, malaise, chills and a mild headache.
Release 11 — 12 months, dose 2
Symptoms: Ongoing nasal drainage and feeling pressure and having hearing issues with both ears.
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 | Chills | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Discomfort | · | · | ✓ |
| SD | Facial discomfort | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Hypoacusis | · | · | ✓ |
| SD | Malaise | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SD | Tongue discomfort | ✓ | ✓ | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Rhinorrhoea | ✓ | ✓ | ✓ |
| SRO | Tinnitus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release