3UM-16472-20894
3 vaccinations
9 coded responses
22 check-ins
9 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 201 / VA
- Registered
- 2021-03-23
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Registered dependents
42J-21929-57499
Child or adolescent in my care · Male · 2022-09-28
Timeline
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2021-03-22
Dose 1 — Moderna
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2021-03-23
Registered in v-safe
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2021-03-26
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: ** since it is now four days since my vaccination, I am describing only the first two days when there was mild soreness at injection site . It is now gone.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-27
Survey response — days 1–6 daily, dose 1MedDRA: Adverse reaction — Feeling: GoodFree text: My shot was 3/22 Monday , 5 days ago I felt site soreness for about 2-3 days , mildMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-28
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: GoodFree text: No but FYI I only got the first survey about 3-4 days after my vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-29
Survey response — day 7, dose 1MedDRA: No adverse event — Feeling: GoodFree text: It has been one week since my vaccine 3/22MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-05
- 2021-04-12
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2021-04-19
Dose 2 — Moderna
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2021-04-19
Survey response — day 0, dose 2MedDRA: Fatigue — Feeling: Good · Fatigue or tirednessFree text: It has only been 5 hrs since my vaccine ; I am usually tiredMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-20
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia, Feeling hot, Insomnia, Pyrexia — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Difficulty sleeping because of joint pain, warm but not feverish.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-21
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: Pain at injection VERY mild, only if I press on it , no bruiseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-22
Survey response — days 1–6 daily, dose 2MedDRA: Feeling abnormal, Myalgia, Poor quality sleep, Somnolence — Feeling: Fair · Fatigue or tirednessFree text: When I had muscle soreness on on the first evening and day 2, I felt foggy headed and drowsy and even more than expected from the poor night of sleepMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-23
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: GoodFree text: All good!MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-24
- 2021-04-25
- 2021-04-28
- 2021-05-03
- 2021-05-10
- 2021-05-19
- 2021-05-24
- 2021-06-02
- 2021-07-19
- 2021-10-18
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2021-11-19
Dose 3 — Moderna
- 2022-04-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-22 | Moderna | |
| 2 | 2021-04-19 | Moderna | |
| 3 | 2021-11-19 | Moderna | No |
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): ** since it is now four days since my vaccination, I am describing only the first two days when there was mild soreness at injection site . It is now gone.
Systemic reaction (other): My shot was 3/22 Monday , 5 days ago I felt site soreness for about 2-3 days , mild
Systemic reaction (other): No but FYI I only got the first survey about 3-4 days after my vaccine
Release 6 — day 7, dose 1
Systemic reaction (other): It has been one week since my vaccine 3/22
Release 7 — day 0, dose 2
Systemic reaction (other): It has only been 5 hrs since my vaccine ; I am usually tired
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Difficulty sleeping because of joint pain, warm but not feverish.
Systemic reaction (other): Pain at injection VERY mild, only if I press on it , no bruise
Systemic reaction (other): When I had muscle soreness on on the first evening and day 2, I felt foggy headed and drowsy and even more than expected from the poor night of sleep
Systemic reaction (other): All good!
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 |
|---|---|---|---|---|
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Feeling hot | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Insomnia | ✓ | ✓ | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Poor quality sleep | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Somnolence | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release