3UA-63570-12405
5 vaccinations
5 coded responses
55 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 302 / GA
- Registered
- 2021-03-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-10
Registered in v-safe
-
2021-03-10
Dose 1 — Moderna
- 2021-03-23
- 2021-03-25
- 2021-03-31
-
2021-04-07
Dose 2 — Moderna
- 2021-04-07
-
2021-04-08
Survey response — days 1–6 daily, dose 2MedDRA: Insomnia — Feeling: Good · Site: PainFree text: Woke up several times during the night but each time I was fine with no feverMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-09
-
2021-04-10
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: On other arm probably related to pool but unsureMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-11
- 2021-04-12
- 2021-04-13
- 2021-04-14
- 2021-04-21
- 2021-04-28
- 2021-05-06
- 2021-05-18
- 2021-05-19
- 2021-07-07
- 2021-10-06
-
2021-10-23
Dose 3 — Moderna
- 2021-10-23
-
2021-10-24
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: Feeling hot — Feeling: Good · Site: PainFree text: Felt hot faced 2 days ago but missed the vcheck windowMedDRA releases: 2024-11 · check-in free text available
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-11-06
- 2021-11-15
- 2021-11-20
- 2021-11-27
- 2021-12-04
- 2022-01-24
-
2022-04-18
Dose 4 — Moderna
- 2022-04-18
-
2022-04-19
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tiredness, Abdominal painAdult check-in
- 2022-04-20
- 2022-04-22
- 2022-04-23
- 2022-04-24
- 2022-04-25
- 2022-05-02
- 2022-05-09
- 2022-05-16
- 2022-05-23
- 2022-05-30
- 2022-07-18
-
2022-08-27
Dose 5 — Moderna
- 2022-08-27
-
2022-08-28
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain, Redness, Swelling · Abdominal painAdult check-in
-
2022-08-29
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness, Abdominal painAdult check-in
- 2022-08-31
- 2022-09-03
- 2022-09-10
-
2022-09-19
Survey response — day 21, dose 5MedDRA: Abdominal pain, Gastrointestinal pain, Self-medication — Feeling: GoodFree text: Strong abdominal pain while sleeping. Got up and walked. Felt pain move thru my intestines. I took pepto bismol thinking it was either acid pain, gas or diarrhea. I felt the pain go all the way down. I never had diarrhea just normal bm when I woke upMedDRA releases: 2024-11 · check-in free text available
- 2022-09-24
- 2022-10-01
- 2022-10-08
-
2022-11-26
Survey response — 3 months, dose 5MedDRA: Nasopharyngitis, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Sinus cold.MedDRA releases: 2024-11 · check-in free text available
-
2022-11-26
Report sent to call center — 3 months, dose 5Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-11-28
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2023-02-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-10 | Moderna | |
| 2 | 2021-04-07 | Moderna | |
| 3 | 2021-10-23 | Moderna | No |
| 4 | 2022-04-18 | Moderna | No |
| 5 | 2022-08-27 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Woke up several times during the night but each time I was fine with no fever
Systemic reaction (other): On other arm probably related to pool but unsure
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Felt hot faced 2 days ago but missed the vcheck window
Release 12 — day 21, dose 5
Symptoms: Strong abdominal pain while sleeping. Got up and walked. Felt pain move thru my intestines. I took pepto bismol thinking it was either acid pain, gas or diarrhea. I felt the pain go all the way down. I never had diarrhea just normal bm when I woke up cut off by CDC
Release 12 — 3 months, dose 5
Symptoms: Sinus cold.
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 | · | · | ✓ |
| SD | Gastrointestinal pain | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Unevaluable event | · | · | ✓ |
| SRO | Feeling hot | · | · | ✓ |
| SRO | Insomnia | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release