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
-
2021-01-23
Dose 1 — Moderna
-
2021-01-24
Registered in v-safe
-
2021-01-24
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling · Muscle or body achesAdult check-in
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-01-30
-
2021-02-06
Survey response — day 14, dose 1MedDRA: Ageusia, Dysgeusia, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: GoodFree 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
- 2021-02-13
- 2021-02-20
- 2021-02-27
-
2021-02-28
Dose 2 — Moderna
-
2021-03-06
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Dizziness, Gaze palsy, Nausea, Pain, Pyrexia — Feeling: Good · Site: Pain, Swelling, ItchingFree 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 achesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-07
- 2021-03-14
- 2021-03-21
- 2021-03-28
- 2021-04-04
- 2021-04-13
-
2021-05-30
Survey response — 3 months, dose 2MedDRA: Cardiac flutter — Feeling: GoodFree 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
-
2021-11-02
Dose 3 — Moderna
- 2021-12-06
- 2021-12-07
- 2021-12-14
- 2022-02-01
-
2022-05-05
Survey response — 6 months, dose 3MedDRA: Dysgeusia, Nasopharyngitis, Tinnitus — Feeling: GoodFree 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
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-23 | Moderna | |
| 2 | 2021-02-28 | Moderna | |
| 3 | 2021-11-02 | Moderna | No |
Free text
Release 3 — day 14, dose 1
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
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
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
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Ageusia | ✓ | ✓ | ✓ |
| SD | Cardiac flutter | ✓ | ✓ | ✓ |
| SD | Dysgeusia | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SD | Tinnitus | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Gaze palsy | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release