3VD-16722-70304
4 vaccinations
7 coded responses
34 check-ins
6 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 200 / DC
- Registered
- 2021-01-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-12
Dose 1 — Moderna
-
2021-01-14
Registered in v-safe
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-17
-
2021-01-18
Survey response — days 1–6 daily, dose 1MedDRA: Axillary pain — Feeling: GoodFree text: Slight soreness in the armpit of the arm where I received the vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-19
Survey response — day 7, dose 1MedDRA: Axillary mass, Axillary pain — Feeling: GoodFree text: Soreness and small lump in armpit of arm where I received the vaccine. I plan to consult my personal doctor about it.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-26
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2021-02-02
Survey response — day 21, dose 1MedDRA: Eye haemorrhage — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Burst blood vessel in eyeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-02
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-09
-
2021-02-10
Dose 2 — Moderna
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2021-02-10
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Chills, Fatigue or tirednessAdult check-in
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2021-02-11
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-12
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-24
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-05-12
- 2021-06-16
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2021-08-13
Survey response — 6 months, dose 2MedDRA: Nasopharyngitis — Feeling: GoodFree text: Cold symptomsMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-09-25
Dose 3 — ModernaCo-administered: Flu
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2021-10-27
Survey response — day 28, dose 3MedDRA: Fatigue, Headache, Rash, Self-medication — Feeling: GoodFree text: Fatigue and headache for 2 days after receiving third Moderna vaccine and flu vaccine at same time. Rash on chest noticed 30 hours after vaccines, which did not respond to Benadryl.MedDRA releases: 2024-11 · check-in free text available
- 2021-10-30
- 2021-11-06
- 2021-12-25
- 2022-03-26
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2022-04-07
Dose 4 — Moderna
- 2022-04-15
-
2022-05-06
Survey response — day 28, dose 4MedDRA: Medical counselling, Nasal congestion — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Nasal congestion · Healthcare visit (other): Visit to hotel by physician to provide a fit to fly certificateMedDRA releases: 2024-11 · check-in free text available
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2022-05-06
Report sent to call center — day 28, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2022-05-06
- 2022-05-06
- 2022-05-12
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2022-05-12
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-05-12
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-05-22
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2023-04-07
Survey response — 12 months, dose 4MedDRA: Nasopharyngitis, Sinusitis — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
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2023-04-07
Report sent to call center — 12 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2023-04-10
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-12 | Moderna | |
| 2 | 2021-02-10 | Moderna | |
| 3 | 2021-09-25 | Moderna | Flu |
| 4 | 2022-04-07 | Moderna | No |
Call center
3 call center cases
3 successful
1 wait over 3 months for a first call
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Slight soreness in the armpit of the arm where I received the vaccine
Release 2 — day 7, dose 1
Systemic reaction (other): Soreness and small lump in armpit of arm where I received the vaccine. I plan to consult my personal doctor about it.
Release 3 — day 21, dose 1
Symptoms: Burst blood vessel in eye
Release 9 — 6 months, dose 2
Symptoms: Cold symptoms
Release 10 — day 28, dose 3
Symptoms: Fatigue and headache for 2 days after receiving third Moderna vaccine and flu vaccine at same time. Rash on chest noticed 30 hours after vaccines, which did not respond to Benadryl.
Release 11 — day 28, dose 4
Symptoms: Nasal congestion
Healthcare visit (other): Visit to hotel by physician to provide a fit to fly certificate
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 | Medical counselling | · | · | ✓ |
| SD | Eye haemorrhage | ✓ | ✓ | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Nasopharyngitis | ✓ | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SRO | Axillary mass | ✓ | ✓ | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release