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3KN-28935-64477

4 vaccinations 4 coded responses 10 check-ins 4 free-text entries 0 call cases
Sex
Female
Age at first dose
51-55
ZIP prefix
300 / GA
Registered
2021-04-24
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
LAF-24963-36366 Child or adolescent in my care · Female · 2021-11-18

Timeline

  1. 2021-03-24
    Dose 1 — Moderna
  2. 2021-04-22
    Dose 2 — Moderna
  3. 2021-04-24
    Registered in v-safe
  4. 2021-04-24
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pyrexia, Vomiting — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities
    Free text: Symptoms have improved from yesterday when I was vomiting and had a fever of between 102 and 103 F for about 12 hours.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-05-01
    Health check-in — day 7, dose 2
    Feeling: Poor · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  6. 2021-12-23
    Dose 3 — Moderna
  7. 2021-12-23
    Survey response — day 0, dose 3
    MedDRA: Arthralgia, Chills, Immediate post-injection reaction — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Joint pain started within 30 minutes after injection. Extreme chills started at 3.5 hours post injection. All symptoms worsening
    MedDRA releases: 2024-11 · check-in free text available
  8. 2021-12-24
    Survey response — days 1–6 daily, dose 3
    MedDRA: Self-medication, Urticaria — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities
    Free text: I developed hives yesterday about 6 hours post injection. They responded to a dose of fexafenodene (180mg Allegra 24 hour) and external witch hazel spray (because I didn't want to add anything heavier into the mix).
    MedDRA releases: 2024-11 · check-in free text available
  9. 2021-12-25
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain, Redness, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  10. 2021-12-26
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site
    Adult check-in
  11. 2021-12-27
    Health check-in — days 1–6 daily, dose 3
    Feeling: Poor · Site: Itching · Fever · Headache, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities
    Adult check-in
  12. 2021-12-28
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Fever · Fatigue or tiredness, Nausea, Abdominal pain
    Adult check-in
  13. 2021-12-29
    Survey response — days 1–6 daily, dose 3
    MedDRA: Facial pain, Pain in jaw, Sinus headache, Toothache — Feeling: Poor · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to do your normal daily activities
    Free text: Sinus headachecheekbones and upper teeth/jaw hurt
    MedDRA releases: 2024-11 · check-in free text available
  14. 2022-05-18
    Dose 4 — Moderna
  15. 2022-05-21
    Health check-in — days 1–6 daily, dose 4
    Feeling: Fair · Site: Swelling, Itching · Fatigue or tiredness
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-24Moderna
22021-04-22Moderna
32021-12-23Moderna No
42022-05-18Moderna No

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-24

Systemic reaction (other): Symptoms have improved from yesterday when I was vomiting and had a fever of between 102 and 103 F for about 12 hours.

Release 10 — day 0, dose 3

2021-12-23

Systemic reaction (other): Joint pain started within 30 minutes after injection. Extreme chills started at 3.5 hours post injection. All symptoms worsening

Release 10 — days 1–6 daily, dose 3

2021-12-24

Systemic reaction (other): I developed hives yesterday about 6 hours post injection. They responded to a dose of fexafenodene (180mg Allegra 24 hour) and external witch hazel spray (because I didn't want to add anything heavier into the mix).

2021-12-29

Systemic reaction (other): Sinus headachecheekbones and upper teeth/jaw hurt

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

FieldPreferred term2021-092023-042024-11
SROArthralgia · · ✓
SROChills · · ✓
SROFacial pain · · ✓
SROImmediate post-injection reaction · · ✓
SROPain in jaw · · ✓
SROPyrexia ✓ ✓ ✓
SROSelf-medication · · ✓
SROSinus headache · · ✓
SROToothache · · ✓
SROUrticaria · · ✓
SROVomiting ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release