3WY-16936-11110
2 vaccinations
4 coded responses
17 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 528 / IA
- Registered
- 2021-02-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-02
Dose 1 — Moderna
-
2021-02-03
Registered in v-safe
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2021-02-03
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: Fair · Site: Pain · Chills · Be unable to workFree text: Felt fainty this morningMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-04
- 2021-02-05
- 2021-02-06
- 2021-02-07
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2021-02-08
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness, Syncope — Feeling: Fair · Fatigue or tirednessFree text: Fainty/dizzy feelingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-09
Health check-in — day 7, dose 1Feeling: Good · Site: Redness, Itching · Fatigue or tirednessAdult check-in
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2021-02-16
Survey response — day 14, dose 1MedDRA: Abdominal discomfort, Asthenia, Back pain, Decreased appetite, Fatigue, Feeling abnormal, Feeling of body temperature change, Medical counselling, Pain, SARS-CoV-2 test negative — Feeling: Good · Be unable to work, Get care from a doctor or other healthcare professionalFree text: Symptoms: Cold/hot- but no temp; no energy; not hungry; extremely tired; felt in a fog; body/back aches; tight tummy feeling · Healthcare visit (other): Phone call to my doctor for advice; had a rapid COVID test but was negative; told t o push fluids/rest- if not feeling better soon to call back for an appointmentMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-16
Report sent to call center — day 14, dose 1Be unable to work · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-23
-
2021-03-02
Dose 2 — Moderna
- 2021-03-03
-
2021-03-04
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-03-05
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-06
- 2021-03-07
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2021-03-08
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Abdominal pain · Be unable to workAdult check-in
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2021-03-09
Health check-in — day 7, dose 2Feeling: Fair · Muscle or body aches, Abdominal pain · Be unable to workAdult check-in
- 2021-08-05
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2021-09-02
Survey response — 6 months, dose 2MedDRA: Abdominal pain, Gastrointestinal stromal tumour, Neoplasm malignant, Office visit — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: I started having horrible abdominal pain and after seeing my doctor was diagnosed with cancer in March, 2021- a GIST tumor: Gastro Intestinal Stromal Tumor. · Healthcare visit (other): My regular doctor and then an oncologistMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-09-02
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2021-09-07
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-02 | Moderna | |
| 2 | 2021-03-02 | Moderna |
Call center
2 call center cases
2 unsuccessful
1 wait over 3 months for a first call
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Felt fainty this morning
Systemic reaction (other): Fainty/dizzy feeling
Release 4 — day 14, dose 1
Symptoms: Cold/hot- but no temp; no energy; not hungry; extremely tired; felt in a fog; body/back aches; tight tummy feeling
Healthcare visit (other): Phone call to my doctor for advice; had a rapid COVID test but was negative; told t o push fluids/rest- if not feeling better soon to call back for an appointment
Release 9 — 6 months, dose 2
Symptoms: I started having horrible abdominal pain and after seeing my doctor was diagnosed with cancer in March, 2021- a GIST tumor: Gastro Intestinal Stromal Tumor.
Healthcare visit (other): My regular doctor and then an oncologist
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 | ✓ | ✓ | ✓ |
| HCVO | Office visit | ✓ | · | ✓ |
| HCVO | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SD | Abdominal discomfort | ✓ | ✓ | ✓ |
| SD | Abdominal pain | ✓ | · | ✓ |
| SD | Asthenia | ✓ | ✓ | ✓ |
| SD | Back pain | ✓ | ✓ | ✓ |
| SD | Decreased appetite | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Feeling abnormal | ✓ | ✓ | ✓ |
| SD | Feeling of body temperature change | ✓ | ✓ | ✓ |
| SD | Gastrointestinal stromal tumour | ✓ | · | ✓ |
| SD | Neoplasm malignant | ✓ | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Syncope | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release