3NQ-13632-80280
3 vaccinations
8 coded responses
34 check-ins
8 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 018 / MA
- Registered
- 2021-01-25
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
RDW-79228-46413
Child or adolescent in my care · Male · 2021-11-06
ZRS-32197-46345
Child or adolescent in my care · Female · 2021-11-06
Timeline
-
2021-01-15
Dose 1 — Moderna
-
2021-01-25
Registered in v-safe
- 2021-01-25
- 2021-01-29
- 2021-02-05
-
2021-02-12
Dose 2 — Moderna
-
2021-02-12
Survey response — day 0, dose 2MedDRA: Cough, Nasopharyngitis, Respiratory tract congestion, SARS-CoV-2 test negative — Feeling: Fair · Site: PainFree text: I have had a cold this week, so I am congested and have a mild cough (tested negative for Covid on 2/8/21)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-13
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tirednessAdult check-in
-
2021-02-14
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Good · Site: PainFree text: Light headedness a couple times, but nothing majorMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-26
- 2021-03-05
- 2021-03-14
- 2021-03-19
- 2021-03-26
- 2021-05-14
- 2021-08-13
-
2021-11-30
Dose 3 — Moderna
- 2021-11-30
-
2021-12-01
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend schoolAdult check-in
-
2021-12-02
Survey response — days 1–6 daily, dose 3MedDRA: Abdominal pain, Flatulence, Irritable bowel syndrome, Pre-existing disease — Feeling: Good · Site: PainFree text: Woke up with Gassy abdominal pain, but I have IBS so could have nothing to do with shotMedDRA releases: 2024-11 · check-in free text available
- 2021-12-03
- 2021-12-04
- 2021-12-05
- 2021-12-06
- 2021-12-07
- 2021-12-14
-
2021-12-23
Survey response — day 21, dose 3MedDRA: Diarrhoea — Feeling: GoodFree text: Diarrhea last weekendMedDRA releases: 2024-11 · check-in free text available
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2021-12-28
Survey response — day 28, dose 3MedDRA: Headache, Pyrexia, Respiratory tract congestion, Rhinorrhoea — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Fever, congestion, headache, runny noseMedDRA releases: 2024-11 · check-in free text available
- 2022-01-04
- 2022-01-11
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2022-03-02
Survey response — 3 months, dose 3MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: GoodFree text: Cold symptoms (not covid positive)MedDRA releases: 2024-11 · check-in free text available
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2022-05-31
Survey response — 6 months, dose 3MedDRA: Ageusia, Anosmia, COVID-19, Cough, Dizziness, Fatigue, Headache, Pain, Pyrexia, Respiratory tract congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Covid - fever, body aches, cough, dizziness, congestion, severe headache, fatigue, loss of taste and smell (from congestion)MedDRA releases: 2024-11 · check-in free text available
-
2022-11-30
Survey response — 12 months, dose 3MedDRA: Diarrhoea, Headache, Pyrexia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Diarrhea, fever, headache over past 36 hoursMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Moderna | |
| 2 | 2021-02-12 | Moderna | |
| 3 | 2021-11-30 | Moderna | No |
Free text
Release 4 — day 0, dose 2
Systemic reaction (other): I have had a cold this week, so I am congested and have a mild cough (tested negative for Covid on 2/8/21)
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Light headedness a couple times, but nothing major
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Woke up with Gassy abdominal pain, but I have IBS so could have nothing to do with shot
Release 10 — day 21, dose 3
Symptoms: Diarrhea last weekend
Release 10 — day 28, dose 3
Symptoms: Fever, congestion, headache, runny nose
Release 11 — 3 months, dose 3
Symptoms: Cold symptoms (not covid positive)
Release 11 — 6 months, dose 3
Symptoms: Covid - fever, body aches, cough, dizziness, congestion, severe headache, fatigue, loss of taste and smell (from congestion)
Release 12 — 12 months, dose 3
Symptoms: Diarrhea, fever, headache over past 36 hours
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 | Anosmia | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Abdominal pain | · | · | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Flatulence | · | · | ✓ |
| SRO | Irritable bowel syndrome | · | · | ✓ |
| SRO | Nasopharyngitis | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SRO | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release