3TU-17025-94747
4 vaccinations
6 coded responses
54 check-ins
6 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 378 / TN
- Registered
- 2021-03-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-01
Dose 1 — Moderna
-
2021-03-02
Registered in v-safe
- 2021-03-02
-
2021-03-03
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: Good · Muscle or body achesFree text: Arm a little sore where COVID19 #1 injection on 3/1/21 was injected but not what I could call pain. Doing great.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-15
- 2021-03-22
-
2021-03-29
Dose 2 — Moderna
- 2021-03-29
- 2021-03-30
- 2021-03-31
- 2021-04-01
- 2021-04-02
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-12
- 2021-04-19
-
2021-04-26
Survey response — day 28, dose 2MedDRA: Office visit, Renal impairment — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: For some reason my kidney function has dropped. March 19 it was 55. April 16 it was rechecked. It was down to 50. Rechecked kidney function today 4/26/21. This is not normal for me. My kidney function has always been greater than the normal of 60. · Healthcare visit (other): I saw my regular medical doctor.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-26
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-03
- 2021-05-10
- 2021-06-28
- 2021-09-27
-
2021-10-22
Dose 3 — Moderna
-
2021-10-22
Survey response — day 0, dose 3MedDRA: No adverse event — Feeling: Good · Site: PainFree text: NoMedDRA releases: 2024-11 · check-in free text available
- 2021-10-23
- 2021-10-24
- 2021-10-25
- 2021-10-26
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-11-05
- 2021-11-12
- 2021-11-19
- 2021-11-26
- 2021-12-03
- 2022-01-23
-
2022-04-08
Dose 4 — Moderna
-
2022-04-08
Survey response — day 0, dose 4MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: Right arm just sore at injection site.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-09
Survey response — days 1–6 daily, dose 4MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: Arm still sore @ injection site. Ice pack helps.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-10
- 2022-04-11
-
2022-04-11
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-04-12
- 2022-04-13
- 2022-04-14
- 2022-04-15
- 2022-04-22
- 2022-04-29
- 2022-05-06
- 2022-05-13
- 2022-05-20
- 2022-07-08
-
2022-10-07
Survey response — 6 months, dose 4MedDRA: COVID-19, Ear infection, Office visit, SARS-CoV-2 test positive — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: COVID19 diagnosis, took antiviral medication , 12 days after first positive Covid test positive + returning Covid symptoms again. Ear infection. Took antibiotics 17 days. · Healthcare visit (other): My medical doctor.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-07
Report sent to call center — 6 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2022-10-10
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2023-04-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-01 | Moderna | |
| 2 | 2021-03-29 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
| 4 | 2022-04-08 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Arm a little sore where COVID19 #1 injection on 3/1/21 was injected but not what I could call pain. Doing great.
Release 8 — day 28, dose 2
Symptoms: For some reason my kidney function has dropped. March 19 it was 55. April 16 it was rechecked. It was down to 50. Rechecked kidney function today 4/26/21. This is not normal for me. My kidney function has always been greater than the normal of 60. cut off by CDC
Healthcare visit (other): I saw my regular medical doctor.
Release 10 — day 0, dose 3
Systemic reaction (other): No
Release 11 — day 0, dose 4
Systemic reaction (other): Right arm just sore at injection site.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Arm still sore @ injection site. Ice pack helps.
Release 12 — 6 months, dose 4
Symptoms: COVID19 diagnosis, took antiviral medication , 12 days after first positive Covid test positive + returning Covid symptoms again. Ear infection. Took antibiotics 17 days.
Healthcare visit (other): My medical doctor.
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 |
|---|---|---|---|---|
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Ear infection | · | · | ✓ |
| SD | Renal impairment | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | No adverse event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release