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3X7-11093-34031

2 vaccinations 6 coded responses 19 check-ins 6 free-text entries 0 call cases
Sex
Female
Age at first dose
46-50
ZIP prefix
481 / MI
Registered
2021-04-22
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
F87-30311-35501 Child or adolescent in my care · Male · 2021-08-23
73W-33689-97561 Child or adolescent in my care · Male · 2021-08-23

Timeline

  1. 2021-04-22
    Registered in v-safe
  2. 2021-04-22
    Dose 1 — Moderna
  3. 2021-04-23
    Survey response — days 1–6 daily, dose 1
    MedDRA: Chills, Pain, Pyrexia — Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: fever 100.7, chills, body aches 6 hours after shot
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-04-25
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  5. 2021-04-26
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-04-27
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Headache
    Adult check-in
  7. 2021-04-29
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-05-08
    Health check-in — day 14, dose 1
    Feeling: Fair
    Adult check-in
  9. 2021-05-16
    Survey response — day 21, dose 1
    MedDRA: Dizziness, Fatigue, Sinusitis — Feeling: Poor · Be unable to do your normal daily activities
    Free text: sinusitis, light headed, tired
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-05-20
    Dose 2 — Moderna
  11. 2021-05-21
    Survey response — days 1–6 daily, dose 2
    MedDRA: Migraine — Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Nausea · Be unable to do your normal daily activities
    Free text: migraine 1st night and day 2
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-05-22
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Muscle or body aches, Nausea
    Adult check-in
  13. 2021-05-23
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Headache, Fatigue or tiredness
    Adult check-in
  14. 2021-05-24
    Survey response — days 1–6 daily, dose 2
    MedDRA: Headache, Muscle tightness, Musculoskeletal stiffness, Neck pain — Feeling: Good · Site: Pain · Headache
    Free text: still tight jaw/intermittent neck head stiffness/aching
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-05-25
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-05-28
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-06-03
    Health check-in — day 14, dose 2
    Feeling: Fair
    Adult check-in
  18. 2021-06-12
    Survey response — day 21, dose 2
    MedDRA: Abnormal menstrual clots, Back pain, Dysmenorrhoea, Heavy menstrual bleeding, Menstrual disorder — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: 2nd menstruation cycle that has been severe compared to cycles before both shots. Heavy, worse cramps, severe low back pain, black jelly large pieces that did not occur before the vaccines.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  19. 2021-06-20
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-06-24
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-07-02
    Survey response — day 42, dose 2
    MedDRA: Arthralgia, Pain in extremity — Feeling: Fair
    Free text: painful joints shoulder-arm pain again for no apparent reason
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-08-19
    Health check-in — 3 months, dose 2
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-04-22Moderna
22021-05-20Moderna

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-23

Systemic reaction (other): fever 100.7, chills, body aches 6 hours after shot

Release 8 — day 21, dose 1

2021-05-16

Symptoms: sinusitis, light headed, tired

Release 8 — days 1–6 daily, dose 2

2021-05-21

Systemic reaction (other): migraine 1st night and day 2

2021-05-24

Systemic reaction (other): still tight jaw/intermittent neck head stiffness/aching

Release 9 — day 21, dose 2

2021-06-12

Symptoms: 2nd menstruation cycle that has been severe compared to cycles before both shots. Heavy, worse cramps, severe low back pain, black jelly large pieces that did not occur before the vaccines.

Release 9 — day 42, dose 2

2021-07-02

Symptoms: painful joints shoulder-arm pain again for no apparent reason

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

FieldPreferred term2021-092023-042024-11
SDAbnormal menstrual clots ✓ ✓ ✓
SDArthralgia ✓ ✓ ✓
SDBack pain ✓ ✓ ✓
SDDizziness ✓ ✓ ✓
SDDysmenorrhoea ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDHeavy menstrual bleeding ✓ ✓ ✓
SDMenstrual disorder ✓ ✓ ✓
SDPain in extremity ✓ ✓ ✓
SDSinusitis ✓ ✓ ✓
SROChills ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SROMigraine ✓ ✓ ✓
SROMuscle tightness ✓ ✓ ✓
SROMusculoskeletal stiffness ✓ ✓ ✓
SRONeck pain ✓ ✓ ✓
SROPain ✓ ✓ ✓
SROPyrexia ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release

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