3R8-22413-20352
3 vaccinations
5 coded responses
25 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 272 / NC
- Registered
- 2021-02-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-08
Registered in v-safe
-
2021-02-08
Dose 1 — Moderna
- 2021-02-08
-
2021-02-09
Survey response — days 1–6 daily, dose 1MedDRA: Feeling cold, Middle insomnia — Feeling: Good · Site: Pain · HeadacheFree text: During last night, sleeping, I felt cold all night. Not sweats, not fever, just cold. I woke up throughout the night, but went back to sleep. I woke up early.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-10
-
2021-02-11
Health check-in — days 1–6 daily, dose 1Feeling: Good · Diarrhea · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-22
- 2021-03-01
- 2021-03-08
-
2021-03-12
Dose 2 — Moderna
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-26
- 2021-04-02
- 2021-04-09
- 2021-04-16
- 2021-04-23
-
2021-06-11
Survey response — 3 months, dose 2MedDRA: Nasopharyngitis, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Cold. Sore throat, runny nose, probably caught from my 5 year old granddaughter; we both had a negative Covid molecule test.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-06-11
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-22
-
2021-06-23
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-09-10
Survey response — 6 months, dose 2MedDRA: Tympanic membrane disorder — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Retracted eardrumMedDRA releases: 2024-11 · check-in free text available
-
2021-09-10
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-14
-
2021-11-02
Dose 3 — Moderna
-
2022-03-12
Survey response — 12 months, dose 2MedDRA: Deafness neurosensory, Meniere's disease, Sudden hearing loss, Vasculitis — Feeling: Good · Be unable to do your normal daily activitiesFree text: SSNHL in left ear Vasculitis in left ear Menieres DiseaseMedDRA releases: 2024-11 · check-in free text available
- 2022-05-03
-
2022-11-02
Survey response — 12 months, dose 3MedDRA: Headache, Immune system disorder, Oropharyngeal pain, Pre-existing disease, Productive cough, Respiratory tract congestion — Feeling: Poor · Be unable to do your normal daily activitiesFree text: For 3 days, sore throat, wet cough, HA, pcr results pending report. I'll see my MD tomorrow due to chest congestion & my lowered immune system due to methotrexate & prednisone for small vessel vasculitisMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-08 | Moderna | |
| 2 | 2021-03-12 | Moderna | |
| 3 | 2021-11-02 | Moderna | No |
Call center
2 call center cases
1 successful · 1 unsuccessful
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): During last night, sleeping, I felt cold all night. Not sweats, not fever, just cold. I woke up throughout the night, but went back to sleep. I woke up early.
Release 9 — 3 months, dose 2
Symptoms: Cold. Sore throat, runny nose, probably caught from my 5 year old granddaughter; we both had a negative Covid molecule test.
Release 9 — 6 months, dose 2
Symptoms: Retracted eardrum
Release 11 — 12 months, dose 2
Symptoms: SSNHL in left ear Vasculitis in left ear Menieres Disease
Release 12 — 12 months, dose 3
Symptoms: For 3 days, sore throat, wet cough, HA, pcr results pending report. I'll see my MD tomorrow due to chest congestion & my lowered immune system due to methotrexate & prednisone for small vessel vasculitis
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 | Deafness neurosensory | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Immune system disorder | · | · | ✓ |
| SD | Meniere's disease | · | · | ✓ |
| SD | Nasopharyngitis | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Productive cough | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sudden hearing loss | · | · | ✓ |
| SD | Tympanic membrane disorder | · | · | ✓ |
| SD | Vasculitis | · | · | ✓ |
| SRO | Feeling cold | ✓ | ✓ | ✓ |
| SRO | Middle insomnia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release