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3PK-31416-59736

2 vaccinations 8 coded responses 14 check-ins 8 free-text entries 0 call cases
Sex
Female
Age at first dose
46-50
ZIP prefix
425 / KY
Registered
2021-09-04
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
ADM-30965-46624 Child or adolescent in my care · Male · 2021-09-04
TWU-14661-33827 Child or adolescent in my care · Male · 2021-09-04

Timeline

  1. 2021-08-09
    Dose 1 — Moderna
  2. 2021-09-04
    Registered in v-safe
  3. 2021-09-04
    Survey response — day 21, dose 1
    MedDRA: Fatigue, Hypertension — Feeling: Fair
    Free text: I have always blood pressure that is on the low side of normal range. Since the vaccine my blood pressure has stayed between stage 1 and stage 2 hypertension range. We bought a pharmacist recommended blood pressure monitorPlus fatigue
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  4. 2021-09-07
    Dose 2 — Moderna
  5. 2021-09-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Adult check-in
  6. 2021-09-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  7. 2021-09-10
    Survey response — days 1–6 daily, dose 2
    MedDRA: Paraesthesia — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness
    Free text: Tingling in face
    MedDRA releases: 2024-11 · check-in free text available
  8. 2021-09-11
    Survey response — days 1–6 daily, dose 2
    MedDRA: Head discomfort — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness
    Free text: Pressure in head
    MedDRA releases: 2024-11 · check-in free text available
  9. 2021-09-12
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  10. 2021-09-13
    Survey response — days 1–6 daily, dose 2
    MedDRA: Blood pressure increased, Chest pain — Feeling: Fair · Fatigue or tiredness
    Free text: Chest pain and raised blood pressure
    MedDRA releases: 2024-11 · check-in free text available
  11. 2021-09-14
    Survey response — day 7, dose 2
    MedDRA: Chest pain, Constipation, Gastrointestinal disorder — Feeling: Fair · Fatigue or tiredness
    Free text: Slight chest pain - bowel issues of increased constipation that I forgot to mention previously
    MedDRA releases: 2024-11 · check-in free text available
  12. 2021-09-21
    Health check-in — day 14, dose 2
    Feeling: Fair
    Adult check-in
  13. 2021-09-28
    Survey response — day 21, dose 2
    MedDRA: Alopecia — Feeling: Fair
    Free text: Hair still falling out
    MedDRA releases: 2024-11 · check-in free text available
  14. 2021-10-09
    Survey response — day 28, dose 2
    MedDRA: Alopecia, Arthropathy — Feeling: Fair
    Free text: Joints are having issues - hair still falling out
    MedDRA releases: 2024-11 · check-in free text available
  15. 2021-10-12
    Health check-in — day 35, dose 2
    Feeling: Fair
    Adult check-in
  16. 2021-10-19
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in
  17. 2021-12-07
    Survey response — 3 months, dose 2
    MedDRA: Alopecia — Feeling: Fair
    Free text: My hair has been falling out and I can't remember if I put that on my check in. It continues to fall out quite a bit every day.
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-08-09Moderna No
22021-09-07Moderna No

Free text

Release 9 — day 21, dose 1

2021-09-04

Symptoms: I have always blood pressure that is on the low side of normal range. Since the vaccine my blood pressure has stayed between stage 1 and stage 2 hypertension range. We bought a pharmacist recommended blood pressure monitorPlus fatigue

Release 9 — days 1–6 daily, dose 2

2021-09-10

Systemic reaction (other): Tingling in face

2021-09-11

Systemic reaction (other): Pressure in head

2021-09-13

Systemic reaction (other): Chest pain and raised blood pressure

Release 9 — day 7, dose 2

2021-09-14

Systemic reaction (other): Slight chest pain - bowel issues of increased constipation that I forgot to mention previously

Release 9 — day 21, dose 2

2021-09-28

Symptoms: Hair still falling out

Release 10 — day 28, dose 2

2021-10-09

Symptoms: Joints are having issues - hair still falling out

Release 10 — 3 months, dose 2

2021-12-07

Symptoms: My hair has been falling out and I can't remember if I put that on my check in. It continues to fall out quite a bit every day.

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
SDAlopecia · · ✓
SDArthropathy · · ✓
SDFatigue ✓ · ✓
SDHypertension ✓ · ✓
SROBlood pressure increased · · ✓
SROChest pain · · ✓
SROConstipation · · ✓
SROGastrointestinal disorder · · ✓
SROHead discomfort · · ✓
SROParaesthesia · · ✓

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

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