3K2-29320-53887
3 vaccinations
7 coded responses
9 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 333 / FL
- Registered
- 2022-01-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
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2021-03-01
Dose 1 — Moderna
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2021-03-25
Dose 2 — Moderna
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2022-01-05
Dose 3 — Moderna
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2022-01-06
Registered in v-safe
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2022-01-06
Survey response — days 1–6 daily, dose 3MedDRA: Erythema, Headache, Pyrexia, Tinnitus — Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Face redness and tinnitus, headache and feverMedDRA releases: 2024-11 · check-in free text available
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2022-01-08
Survey response — days 1–6 daily, dose 3MedDRA: Eye pain, Headache, Pyrexia, Rash, Tinnitus — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection siteFree text: 1/8 Alternating eye pain. Tinnitus. Elongated oval rash under ea armpit. A few sml bumps on shoulder. Hours after application severe headache & 102 fever. 2nd full day headache mostly gone.MedDRA releases: 2024-11 · check-in free text available
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2022-01-10
Survey response — days 1–6 daily, dose 3MedDRA: Asthenia, Fear, Lymphadenopathy — Feeling: Fair · Site: Swelling · Fatigue or tirednessFree text: Weakness and left armpit lymph nodes swelling. I don't know if I can take the vaccine again. Scared to.MedDRA releases: 2024-11 · check-in free text available
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2022-01-11
Survey response — days 1–6 daily, dose 3MedDRA: Cough, Skin warm — Feeling: Fair · Site: Swelling · FeverFree text: Coughing a lot, son said I felt warm foreheadMedDRA releases: 2024-11 · check-in free text available
- 2022-01-14
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2022-01-19
Survey response — day 14, dose 3MedDRA: Headache, Nasal congestion, Respiratory tract congestion — Feeling: FairFree text: Headache, stuffy nose a little, chest congestion continuesMedDRA releases: 2024-11 · check-in free text available
- 2022-01-26
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2022-02-02
Survey response — day 28, dose 3MedDRA: Alopecia, Cough, Pyrexia — Feeling: FairFree text: Hair loss. I noticed it during 3-Day 102F fever. Cough has not gone. It occurs daily but not as frequent.MedDRA releases: 2024-11 · check-in free text available
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2023-01-07
Survey response — 12 months, dose 3MedDRA: Chest discomfort — Feeling: FairMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-01 | Moderna | No |
| 2 | 2021-03-25 | Moderna | No |
| 3 | 2022-01-05 | Moderna | No |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Face redness and tinnitus, headache and fever
Systemic reaction (other): 1/8 Alternating eye pain. Tinnitus. Elongated oval rash under ea armpit. A few sml bumps on shoulder. Hours after application severe headache & 102 fever. 2nd full day headache mostly gone.
Systemic reaction (other): Weakness and left armpit lymph nodes swelling. I don't know if I can take the vaccine again. Scared to.
Systemic reaction (other): Coughing a lot, son said I felt warm forehead
Release 10 — day 14, dose 3
Symptoms: Headache, stuffy nose a little, chest congestion continues
Release 11 — day 28, dose 3
Symptoms: Hair loss. I noticed it during 3-Day 102F fever. Cough has not gone. It occurs daily but not as frequent.
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 | Alopecia | · | · | ✓ |
| SD | Chest discomfort | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SRO | Asthenia | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Erythema | · | · | ✓ |
| SRO | Eye pain | · | · | ✓ |
| SRO | Fear | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Pyrexia | · | · | ✓ |
| SRO | Rash | · | · | ✓ |
| SRO | Skin warm | · | · | ✓ |
| SRO | Tinnitus | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release