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3KX-19904-56604

3 vaccinations 4 coded responses 24 check-ins 4 free-text entries 0 call cases
Sex
Female
Age at first dose
41-45
ZIP prefix
974 / OR
Registered
2021-01-24
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
NYR-30983-00252 Child or adolescent in my care · Male · 2021-12-04

Timeline

  1. 2021-01-23
    Dose 1 — Moderna
  2. 2021-01-24
    Registered in v-safe
  3. 2021-01-24
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Swelling · Muscle or body aches
    Adult check-in
  4. 2021-01-25
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  5. 2021-01-26
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Itching · None
    Adult check-in
  6. 2021-01-27
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-01-28
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-01-29
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-01-30
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-02-06
    Survey response — day 14, dose 1
    MedDRA: Ageusia, Dysgeusia, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Good
    Free text: One week after the 1st Moderna vaccine, I got a consistent runny nose for 2 days, along with loss of taste and water tasting like dirt for 3/4 of one day. I went in for testing and both the rapid and 3 day tests were negative.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-02-13
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-02-20
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-02-27
    Health check-in — day 35, dose 1
    Feeling: Good
    Adult check-in
  14. 2021-02-28
    Dose 2 — Moderna
  15. 2021-03-06
    Survey response — days 1–6 daily, dose 2
    MedDRA: Chills, Dizziness, Gaze palsy, Nausea, Pain, Pyrexia — Feeling: Good · Site: Pain, Swelling, Itching
    Free text: No symptoms today, but the night after I got the second shot (about 14 hrs after) I had: dizziness, chills, body aches, fever, nausea, and the following day, headache and milder body aches
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-03-07
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-03-14
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-03-21
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-03-28
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-04-04
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-04-13
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-05-30
    Survey response — 3 months, dose 2
    MedDRA: Cardiac flutter — Feeling: Good
    Free text: I did experience some fluttering heart sensation or felt it was a kind of arrhythmia, for a few days on and off. Im not prone to anxiety, it seemed just biological. I wonder about a connection to the vaccine.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  23. 2021-11-02
    Dose 3 — Moderna
  24. 2021-12-06
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  25. 2021-12-07
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  26. 2021-12-14
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  27. 2022-02-01
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  28. 2022-05-05
    Survey response — 6 months, dose 3
    MedDRA: Dysgeusia, Nasopharyngitis, Tinnitus — Feeling: Good
    Free text: Loud tinnitus in left ear after a cold, and strange taste in my mouth and back of throat during and after eating.
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-01-23Moderna
22021-02-28Moderna
32021-11-02Moderna No

Free text

Release 3 — day 14, dose 1

2021-02-06

Symptoms: One week after the 1st Moderna vaccine, I got a consistent runny nose for 2 days, along with loss of taste and water tasting like dirt for 3/4 of one day. I went in for testing and both the rapid and 3 day tests were negative.

Release 5 — days 1–6 daily, dose 2

2021-03-06

Systemic reaction (other): No symptoms today, but the night after I got the second shot (about 14 hrs after) I had: dizziness, chills, body aches, fever, nausea, and the following day, headache and milder body aches

Release 8 — 3 months, dose 2

2021-05-30

Symptoms: I did experience some fluttering heart sensation or felt it was a kind of arrhythmia, for a few days on and off. Im not prone to anxiety, it seemed just biological. I wonder about a connection to the vaccine.

Release 11 — 6 months, dose 3

2022-05-05

Symptoms: Loud tinnitus in left ear after a cold, and strange taste in my mouth and back of throat during and after eating.

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
SDAgeusia ✓ ✓ ✓
SDCardiac flutter ✓ ✓ ✓
SDDysgeusia ✓ ✓ ✓
SDNasopharyngitis · · ✓
SDRhinorrhoea ✓ ✓ ✓
SDSARS-CoV-2 test negative ✓ ✓ ✓
SDTinnitus · · ✓
SROChills ✓ ✓ ✓
SRODizziness ✓ ✓ ✓
SROGaze palsy ✓ ✓ ✓
SRONausea ✓ ✓ ✓
SROPain ✓ ✓ ✓
SROPyrexia ✓ ✓ ✓

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