3WS-17804-65473
4 vaccinations
8 coded responses
39 check-ins
8 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 201 / VA
- Registered
- 2021-01-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-13
Registered in v-safe
-
2021-01-13
Dose 1 — Moderna
- 2021-01-13
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-20
- 2021-01-27
- 2021-02-03
-
2021-02-10
Dose 2 — Moderna
- 2021-02-10
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2021-02-11
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-02-12
Survey response — days 1–6 daily, dose 2MedDRA: Pain in extremity — Feeling: Poor · Site: Pain · Fatigue or tirednessFree text: Arm pain between shoulder and elbowMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 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
Survey response — day 35, dose 2MedDRA: Urinary tract infection — Feeling: FairFree text: Urinary tract infection not related to vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
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2021-05-12
Survey response — 3 months, dose 2MedDRA: Chills, Feeling cold — Feeling: GoodFree text: After the 2nd dose of Moderna, suddenly every afternoon, I get shivery cold, and must wear sweater rest of day. Do not get warm until in bed under quilt. Not know if Moderna related, but came on suddenlyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-08-11
-
2021-08-24
Dose 3 — Moderna
-
2021-11-23
Survey response — 3 months, dose 3MedDRA: Emergency care, Pyrexia, Tremor, Vomiting — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Fluzone flu shot gave me low grade fever and vomiting and shaking in October · Healthcare visit (other): Rescue squadMedDRA releases: 2024-11 · check-in free text available
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2021-11-23
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2021-11-29
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2022-02-22
Survey response — 6 months, dose 3MedDRA: Transient ischaemic attack — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · HospitalizationFree text: TIA Feb 18MedDRA releases: 2024-11 · check-in free text available
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2022-02-22
Report sent to call center — 6 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalHospitalization · 1 call case(s)
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2022-02-24
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-02-24
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2022-08-24
Survey response — 12 months, dose 3MedDRA: Transient ischaemic attack — Feeling: Good · Get care from a doctor or other healthcare professional · HospitalizationFree text: TIA 02/22MedDRA releases: 2024-11 · check-in free text available
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2022-08-24
Report sent to call center — 12 months, dose 3Get care from a doctor or other healthcare professionalHospitalization · 1 call case(s)
- 2022-08-25
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2022-09-23
Dose 4 — Moderna
- 2022-09-25
- 2022-09-26
- 2022-09-27
- 2022-09-28
- 2022-09-29
- 2022-09-30
- 2022-10-07
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2022-10-14
Survey response — day 21, dose 4MedDRA: Lower respiratory tract congestion, Nasal congestion, Office visit, Oropharyngeal pain, Viral infection — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Virus. Sore throat, nasal & bronchial congestion. Went to Urgent Care. No treatment;virus. Not Covid or fluMedDRA releases: 2024-11 · check-in free text available
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2022-10-14
Report sent to call center — day 21, 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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2022-10-18
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-10-18
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-10-21
- 2022-10-28
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2022-11-04
Survey response — day 42, dose 4MedDRA: Bronchiolitis, Influenza virus test negative, Lower respiratory tract congestion, Nasal congestion, Respiratory symptom, SARS-CoV-2 test negative — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Bronchiolitis. Nasal congestion. For three weeks. Symptoms seem to be RSV virus. Doc did strep test,covid test and flu test; all negative. Still have bronchial congestionMedDRA releases: 2024-11 · check-in free text available
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2022-11-04
Report sent to call center — day 42, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-11-07
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 | 2021-01-13 | Moderna | |
| 2 | 2021-02-10 | Moderna | |
| 3 | 2021-08-24 | Moderna | No |
| 4 | 2022-09-23 | Moderna | No |
Call center
5 call center cases
5 successful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Arm pain between shoulder and elbow
Release 5 — day 35, dose 2
Symptoms: Urinary tract infection not related to vaccine
Release 8 — 3 months, dose 2
Symptoms: After the 2nd dose of Moderna, suddenly every afternoon, I get shivery cold, and must wear sweater rest of day. Do not get warm until in bed under quilt. Not know if Moderna related, but came on suddenly
Release 10 — 3 months, dose 3
Symptoms: Fluzone flu shot gave me low grade fever and vomiting and shaking in October
Healthcare visit (other): Rescue squad
Release 11 — 6 months, dose 3
Symptoms: TIA Feb 18
Release 12 — 12 months, dose 3
Symptoms: TIA 02/22
Release 12 — day 21, dose 4
Symptoms: Virus. Sore throat, nasal & bronchial congestion. Went to Urgent Care. No treatment;virus. Not Covid or flu
Release 12 — day 42, dose 4
Symptoms: Bronchiolitis. Nasal congestion. For three weeks. Symptoms seem to be RSV virus. Doc did strep test,covid test and flu test; all negative. Still have bronchial congestion
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 | Emergency care | · | · | ✓ |
| SD | Bronchiolitis | · | · | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Feeling cold | ✓ | ✓ | ✓ |
| SD | Influenza virus test negative | · | · | ✓ |
| SD | Lower respiratory tract congestion | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory symptom | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Transient ischaemic attack | · | · | ✓ |
| SD | Tremor | · | · | ✓ |
| SD | Urinary tract infection | ✓ | ✓ | ✓ |
| SD | Viral infection | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release