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3LS-31401-99668

2 vaccinations 6 coded responses 23 check-ins 6 free-text entries 0 call cases
Sex
Female
Age at first dose
21-25
ZIP prefix
908 / CA
Registered
2021-04-14
Relationship
Self
Race
Other
Ethnicity
Hispanic or Latino

Timeline

  1. 2021-04-13
    Dose 1 — Moderna
  2. 2021-04-14
    Registered in v-safe
  3. 2021-04-14
    Survey response — days 1–6 daily, dose 1
    MedDRA: Chills, Pain in extremity, Self-medication — Feeling: Fair · Site: Pain, Swelling, Itching · Chills, Headache, Muscle or body aches, Fatigue or tiredness
    Free text: The chills they come and go and still have pain on my arm I am taking Tylenone
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-04-15
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pain in extremity — Feeling: Fair · Site: Pain · Headache, Muscle or body aches
    Free text: This day feel much better pain arms goes and come but its less than yestday
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-04-17
    Survey response — days 1–6 daily, dose 1
    MedDRA: Ear pain, Pain in extremity — Feeling: Good
    Free text: Its comes and goes The arm pain but I doesnt hurt I got ear pain and I think its ear infection
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-04-19
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pre-existing disease — Feeling: Good
    Free text: Non I just have my normal allergies its the season time
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-04-20
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-04-27
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  9. 2021-05-04
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-05-11
    Dose 2 — Moderna
  11. 2021-05-11
    Health check-in — day 0, dose 2
    Feeling: Fair · Site: Pain · Fever · Headache
    Adult check-in
  12. 2021-05-12
    Survey response — days 1–6 daily, dose 2
    MedDRA: Eye pruritus — Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities
    Free text: My eyes are itchy
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-05-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Chills, Headache
    Adult check-in
  14. 2021-05-14
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Redness · None
    Adult check-in
  15. 2021-05-15
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Itching · None
    Adult check-in
  16. 2021-05-16
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Itching · None
    Adult check-in
  17. 2021-05-17
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-05-18
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-05-27
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-06-01
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-06-08
    Survey response — day 28, dose 2
    MedDRA: Menstrual disorder — Feeling: Good
    Free text: Did had muiplte periods had to go the doctor gave me medication for having two times period and bleeding . But feeling much better
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-06-15
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-06-22
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-08-10
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-11-09
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  26. 2022-05-11
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-04-13Moderna
22021-05-11Moderna

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-14

Systemic reaction (other): The chills they come and go and still have pain on my arm I am taking Tylenone

2021-04-15

Systemic reaction (other): This day feel much better pain arms goes and come but its less than yestday

2021-04-17

Systemic reaction (other): Its comes and goes The arm pain but I doesnt hurt I got ear pain and I think its ear infection

2021-04-19

Systemic reaction (other): Non I just have my normal allergies its the season time

Release 8 — days 1–6 daily, dose 2

2021-05-12

Systemic reaction (other): My eyes are itchy

Release 8 — day 28, dose 2

2021-06-08

Symptoms: Did had muiplte periods had to go the doctor gave me medication for having two times period and bleeding . But feeling much better

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
SDMenstrual disorder ✓ ✓ ✓
SROChills ✓ ✓ ✓
SROEar pain ✓ ✓ ✓
SROEye pruritus ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓
SROSelf-medication ✓ ✓ ✓

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

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