3QG-22291-93924
5 vaccinations
11 coded responses
55 check-ins
11 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 928 / CA
- Registered
- 2021-02-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-13
Registered in v-safe
-
2021-02-13
Dose 1 — Moderna
- 2021-02-13
- 2021-02-14
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2021-02-15
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: GoodFree text: Just some soreness at the site of injection when I press on it.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
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2021-02-20
Survey response — day 7, dose 1MedDRA: Sciatica — Feeling: GoodFree text: Sciatic pain left side probably unrelated to vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-27
Survey response — day 14, dose 1MedDRA: Abdominal pain lower, Pyrexia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Lower abdominal pain and low grade fever probably not related to vaccine since it started 1 week after!MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-06
Survey response — day 21, dose 1MedDRA: Malaise — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Spent entire week illMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-06
Report sent to call center — day 21, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
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2021-03-13
Survey response — day 28, dose 1MedDRA: Hospitalisation — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · HospitalizationFree text: Hospitalized ruled out stroke and everything else.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-13
Report sent to call center — day 28, dose 1Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-20
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2021-03-22
Dose 2 — Moderna
- 2021-03-22
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2021-03-23
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fatigue or tiredness, NauseaAdult check-in
- 2021-03-24
- 2021-03-25
- 2021-03-26
- 2021-03-27
- 2021-03-28
- 2021-03-29
- 2021-04-05
- 2021-04-12
- 2021-04-19
- 2021-04-26
- 2021-05-03
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2021-06-21
Survey response — 3 months, dose 2MedDRA: Gastrointestinal disorder, Immunisation reaction — Feeling: GoodFree text: Gastrointestinal problems since last vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-09-20
Survey response — 6 months, dose 2MedDRA: Back pain, Lethargy — Feeling: Good · Be unable to do your normal daily activitiesFree text: Lethargic, back painMedDRA releases: 2024-11 · check-in free text available
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2021-10-29
Dose 3 — Moderna
- 2021-10-29
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2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
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2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Injection site pain — Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessFree text: Arm pain below injection siteMedDRA releases: 2024-11 · check-in free text available
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2021-11-01
Survey response — days 1–6 daily, dose 3MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: Pain only at the injection site today!!MedDRA releases: 2024-11 · check-in free text available
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-05
- 2021-11-12
- 2021-11-21
- 2021-11-26
- 2021-12-03
- 2021-12-10
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2021-12-16
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-01-28
- 2022-04-29
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2022-06-04
Dose 4 — Moderna
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2022-06-09
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
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2022-06-10
Survey response — days 1–6 daily, dose 4MedDRA: Epistaxis — Feeling: GoodFree text: Bloody noseMedDRA releases: 2024-11 · check-in free text available
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2022-06-11
Survey response — day 7, dose 4MedDRA: Unevaluable event — Feeling: Good · Fatigue or tirednessFree text: Booster date was 6-3 NOT 6-4MedDRA releases: 2024-11 · check-in free text available
- 2022-06-18
- 2022-06-25
- 2022-07-02
- 2022-07-09
- 2022-07-16
- 2022-09-03
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2022-10-20
Dose 5 — ModernaCo-administered: Flu
- 2022-12-03
- 2022-12-03
- 2023-01-19
- 2023-04-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-13 | Moderna | |
| 2 | 2021-03-22 | Moderna | |
| 3 | 2021-10-29 | Moderna | No |
| 4 | 2022-06-04 | Moderna | No |
| 5 | 2022-10-20 | Moderna | Flu |
Call center
2 call center cases
2 successful
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Just some soreness at the site of injection when I press on it.
Release 4 — day 7, dose 1
Systemic reaction (other): Sciatic pain left side probably unrelated to vaccine
Release 4 — day 14, dose 1
Symptoms: Lower abdominal pain and low grade fever probably not related to vaccine since it started 1 week after!
Release 5 — day 21, dose 1
Symptoms: Spent entire week ill
Release 5 — day 28, dose 1
Symptoms: Hospitalized ruled out stroke and everything else.
Release 9 — 3 months, dose 2
Symptoms: Gastrointestinal problems since last vaccine
Release 9 — 6 months, dose 2
Symptoms: Lethargic, back pain
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Arm pain below injection site
Systemic reaction (other): Pain only at the injection site today!!
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): Bloody nose
Release 12 — day 7, dose 4
Systemic reaction (other): Booster date was 6-3 NOT 6-4
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 | Abdominal pain lower | ✓ | ✓ | ✓ |
| SD | Back pain | · | · | ✓ |
| SD | Gastrointestinal disorder | ✓ | ✓ | ✓ |
| SD | Hospitalisation | ✓ | ✓ | ✓ |
| SD | Immunisation reaction | ✓ | ✓ | ✓ |
| SD | Lethargy | · | · | ✓ |
| SD | Malaise | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Epistaxis | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Sciatica | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release