3PP-27563-11005
2 vaccinations
7 coded responses
24 check-ins
7 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 857 / AZ
- Registered
- 2021-03-04
- Relationship
- Self
- Race
- American Indian or Alaska Native
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-03-04
Registered in v-safe
-
2021-03-04
Dose 1 — Moderna
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-04-01
-
2021-04-03
Dose 2 — Moderna
-
2021-04-03
Survey response — day 0, dose 2MedDRA: Dysgeusia — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activitiesFree text: Taste metals in mouth while eating or not eatingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-04
Survey response — days 1–6 daily, dose 2MedDRA: Erythema, Peripheral swelling, Skin warm — Feeling: Fair · Site: SwellingFree text: Swelling in arm, area red and very warmMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-05
Survey response — days 1–6 daily, dose 2MedDRA: Peripheral swelling, Skin warm, Tenderness — Feeling: Good · Site: SwellingFree text: Vaccinated arm is tender mildly swollen & very warmMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-07
- 2021-04-08
-
2021-04-09
Survey response — days 1–6 daily, dose 2MedDRA: Chest pain — Feeling: Good · HeadacheFree text: My husband who also got his 2nd vaccine on the same day is experiencing chest pains. He contacted his Dr & your website.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-10
Survey response — day 7, dose 2MedDRA: Chest pain, Headache — Feeling: Good · HeadacheFree text: My husband who received his 2nd injection on the same day as me suffers headaches & chest pain.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-19
-
2021-04-25
Survey response — day 21, dose 2MedDRA: Headache — Feeling: FairFree text: Headaches randomly that last the entire day & nightMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-01
Survey response — day 28, dose 2MedDRA: Headache — Feeling: FairFree text: Headaches mildMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-08
- 2021-05-15
- 2021-10-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-04 | Moderna | |
| 2 | 2021-04-03 | Moderna |
Free text
Release 6 — day 0, dose 2
Systemic reaction (other): Taste metals in mouth while eating or not eating
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Swelling in arm, area red and very warm
Systemic reaction (other): Vaccinated arm is tender mildly swollen & very warm
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): My husband who also got his 2nd vaccine on the same day is experiencing chest pains. He contacted his Dr & your website.
Release 7 — day 7, dose 2
Systemic reaction (other): My husband who received his 2nd injection on the same day as me suffers headaches & chest pain.
Release 7 — day 21, dose 2
Symptoms: Headaches randomly that last the entire day & night
Release 8 — day 28, dose 2
Symptoms: Headaches mild
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 | Headache | ✓ | ✓ | ✓ |
| SRO | Chest pain | ✓ | ✓ | ✓ |
| SRO | Dysgeusia | ✓ | ✓ | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Peripheral swelling | ✓ | ✓ | ✓ |
| SRO | Skin warm | ✓ | ✓ | ✓ |
| SRO | Tenderness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release