3LT-14142-47352
3 vaccinations
5 coded responses
40 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 799 / TX
- Registered
- 2021-03-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-03-19
Registered in v-safe
-
2021-03-19
Dose 1 — Moderna
- 2021-03-19
- 2021-03-20
- 2021-03-21
- 2021-03-22
-
2021-03-23
Survey response — days 1–6 daily, dose 1MedDRA: Dyspnoea, Stress — Feeling: GoodFree text: A little shortness of breath over the last three days but this may be also due to stress in the last week.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-04-02
- 2021-04-09
-
2021-04-16
Dose 2 — Moderna
-
2021-04-16
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-17
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-04-19
- 2021-04-20
- 2021-04-21
- 2021-04-22
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-05-14
- 2021-05-21
- 2021-05-28
- 2021-07-17
- 2021-10-15
-
2021-10-28
Dose 3 — Moderna
-
2021-10-28
Health check-in — day 0, dose 3Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-10-29
Survey response — days 1–6 daily, dose 3MedDRA: Oropharyngeal pain — Feeling: Good · Site: PainFree text: Slight sore throatMedDRA releases: 2024-11 · check-in free text available
- 2021-10-30
-
2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Dyspnoea exertional — Feeling: Good · Site: ItchingFree text: A little out of breath when walking uphill, which is not usual.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-01
- 2021-11-02
-
2021-11-03
Survey response — days 1–6 daily, dose 3MedDRA: Rash, Rash pruritic — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: A mid rich around the neck and shoulders, it was a little itchy but it's subsiding fast. This was the case yesterday also, which I forgot to report.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-04
- 2021-11-13
- 2021-11-18
- 2021-11-25
- 2021-12-02
- 2021-12-09
-
2022-01-27
Survey response — 3 months, dose 3MedDRA: Autoimmune hepatitis, Bilirubin conjugated increased, Laboratory test abnormal, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: High direct bilirubin and tested positive for auto-immune hepatitis. · Healthcare visit (other): MriMedDRA releases: 2024-11 · check-in free text available
-
2022-01-27
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professional1 call case(s)
-
2022-02-09
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-04-28
- 2022-10-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-19 | Moderna | |
| 2 | 2021-04-16 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): A little shortness of breath over the last three days but this may be also due to stress in the last week.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Slight sore throat
Systemic reaction (other): A little out of breath when walking uphill, which is not usual.
Systemic reaction (other): A mid rich around the neck and shoulders, it was a little itchy but it's subsiding fast. This was the case yesterday also, which I forgot to report.
Release 11 — 3 months, dose 3
Symptoms: High direct bilirubin and tested positive for auto-immune hepatitis.
Healthcare visit (other): Mri
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 |
|---|---|---|---|---|
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Autoimmune hepatitis | · | · | ✓ |
| SD | Bilirubin conjugated increased | · | · | ✓ |
| SD | Laboratory test abnormal | · | · | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Dyspnoea exertional | · | · | ✓ |
| SRO | Oropharyngeal pain | · | · | ✓ |
| SRO | Rash | · | · | ✓ |
| SRO | Rash pruritic | · | · | ✓ |
| SRO | Stress | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release