3X8-55041-55093
3 vaccinations
9 coded responses
13 check-ins
9 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 661 / KS
- Registered
- 2021-12-20
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-03
Dose 1 — Moderna
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2021-03-31
Dose 2 — Moderna
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2021-12-20
Registered in v-safe
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2021-12-20
Dose 3 — Moderna
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2021-12-21
Survey response — days 1–6 daily, dose 3MedDRA: Headache — Feeling: Good · Site: PainFree text: Headache yesterdayMedDRA releases: 2024-11 · check-in free text available
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2021-12-22
Survey response — days 1–6 daily, dose 3MedDRA: Headache — Feeling: Fair · Site: Pain · HeadacheFree text: The headaches are mild but consistentMedDRA releases: 2024-11 · check-in free text available
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2021-12-23
Survey response — days 1–6 daily, dose 3MedDRA: Headache — Feeling: Good · Site: Pain · HeadacheFree text: Still a mild headacheMedDRA releases: 2024-11 · check-in free text available
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2021-12-24
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Swelling · HeadacheAdult check-in
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2021-12-25
Survey response — days 1–6 daily, dose 3MedDRA: Injection site pain, Neck pain, Pain in extremity — Feeling: Fair · Site: Pain, Swelling · Muscle or body achesFree text: I am not sure but this morning the pain at the shot sight was like going down my arm and up to my neck?MedDRA releases: 2024-11 · check-in free text available
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2021-12-26
Survey response — days 1–6 daily, dose 3MedDRA: Adverse reaction — Feeling: Good · Site: PainFree text: Better todayMedDRA releases: 2024-11 · check-in free text available
- 2021-12-27
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2022-01-03
Survey response — day 14, dose 3MedDRA: Arthralgia — Feeling: FairFree text: Arthritis painMedDRA releases: 2024-11 · check-in free text available
- 2022-01-10
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2022-01-18
Survey response — day 28, dose 3MedDRA: Arthralgia, Loss of personal independence in daily activities — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Arthritis in arms seams to hurt more somewhat harder to do houseworkMedDRA releases: 2024-11 · check-in free text available
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2022-02-01
Survey response — day 42, dose 3MedDRA: Headache, Myalgia — Feeling: FairFree text: For the last month I've been having frequent mild headaches and muscle achesMedDRA releases: 2024-11 · check-in free text available
- 2022-03-21
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2022-06-20
Survey response — 6 months, dose 3MedDRA: Medical counselling, Throat irritation — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: I don't know if it's allergies but I have a constant tickle in my throat · Healthcare visit (other): Called and talker to the doctorMedDRA releases: 2024-11 · check-in free text available
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2022-06-20
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professional1 call case(s)
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2022-06-21
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 | 2021-03-03 | Moderna | No |
| 2 | 2021-03-31 | Moderna | No |
| 3 | 2021-12-20 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Headache yesterday
Systemic reaction (other): The headaches are mild but consistent
Systemic reaction (other): Still a mild headache
Systemic reaction (other): I am not sure but this morning the pain at the shot sight was like going down my arm and up to my neck?
Systemic reaction (other): Better today
Release 10 — day 14, dose 3
Symptoms: Arthritis pain
Release 10 — day 28, dose 3
Symptoms: Arthritis in arms seams to hurt more somewhat harder to do housework
Release 11 — day 42, dose 3
Symptoms: For the last month I've been having frequent mild headaches and muscle aches
Release 12 — 6 months, dose 3
Symptoms: I don't know if it's allergies but I have a constant tickle in my throat
Healthcare visit (other): Called and talker to the doctor
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 | Arthralgia | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Loss of personal independence in daily activities | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Throat irritation | · | · | ✓ |
| SRO | Adverse reaction | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Neck pain | · | · | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release