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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

  1. 2021-03-03
    Dose 1 — Moderna
  2. 2021-03-31
    Dose 2 — Moderna
  3. 2021-12-20
    Registered in v-safe
  4. 2021-12-20
    Dose 3 — Moderna
  5. 2021-12-21
    Survey response — days 1–6 daily, dose 3
    MedDRA: Headache — Feeling: Good · Site: Pain
    Free text: Headache yesterday
    MedDRA releases: 2024-11 · check-in free text available
  6. 2021-12-22
    Survey response — days 1–6 daily, dose 3
    MedDRA: Headache — Feeling: Fair · Site: Pain · Headache
    Free text: The headaches are mild but consistent
    MedDRA releases: 2024-11 · check-in free text available
  7. 2021-12-23
    Survey response — days 1–6 daily, dose 3
    MedDRA: Headache — Feeling: Good · Site: Pain · Headache
    Free text: Still a mild headache
    MedDRA releases: 2024-11 · check-in free text available
  8. 2021-12-24
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain, Swelling · Headache
    Adult check-in
  9. 2021-12-25
    Survey response — days 1–6 daily, dose 3
    MedDRA: Injection site pain, Neck pain, Pain in extremity — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches
    Free 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
  10. 2021-12-26
    Survey response — days 1–6 daily, dose 3
    MedDRA: Adverse reaction — Feeling: Good · Site: Pain
    Free text: Better today
    MedDRA releases: 2024-11 · check-in free text available
  11. 2021-12-27
    Health check-in — day 7, dose 3
    Feeling: Fair · Joint pains, Muscle or body aches
    Adult check-in
  12. 2022-01-03
    Survey response — day 14, dose 3
    MedDRA: Arthralgia — Feeling: Fair
    Free text: Arthritis pain
    MedDRA releases: 2024-11 · check-in free text available
  13. 2022-01-10
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  14. 2022-01-18
    Survey response — day 28, dose 3
    MedDRA: Arthralgia, Loss of personal independence in daily activities — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Arthritis in arms seams to hurt more somewhat harder to do housework
    MedDRA releases: 2024-11 · check-in free text available
  15. 2022-02-01
    Survey response — day 42, dose 3
    MedDRA: Headache, Myalgia — Feeling: Fair
    Free text: For the last month I've been having frequent mild headaches and muscle aches
    MedDRA releases: 2024-11 · check-in free text available
  16. 2022-03-21
    Health check-in — 3 months, dose 3
    Feeling: Fair
    Adult check-in
  17. 2022-06-20
    Survey response — 6 months, dose 3
    MedDRA: Medical counselling, Throat irritation — Feeling: Fair · Get care from a doctor or other healthcare professional
    Free 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 doctor
    MedDRA releases: 2024-11 · check-in free text available
  18. 2022-06-20
    Report sent to call center — 6 months, dose 3
    Get care from a doctor or other healthcare professional
    1 call case(s)
  19. 2022-06-21
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

DoseDateManufacturerCo-administered
12021-03-03Moderna No
22021-03-31Moderna No
32021-12-20Moderna No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 10 — days 1–6 daily, dose 3

2021-12-21

Systemic reaction (other): Headache yesterday

2021-12-22

Systemic reaction (other): The headaches are mild but consistent

2021-12-23

Systemic reaction (other): Still a mild headache

2021-12-25

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?

2021-12-26

Systemic reaction (other): Better today

Release 10 — day 14, dose 3

2022-01-03

Symptoms: Arthritis pain

Release 10 — day 28, dose 3

2022-01-18

Symptoms: Arthritis in arms seams to hurt more somewhat harder to do housework

Release 11 — day 42, dose 3

2022-02-01

Symptoms: For the last month I've been having frequent mild headaches and muscle aches

Release 12 — 6 months, dose 3

2022-06-20

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

FieldPreferred term2021-092023-042024-11
HCVOMedical counselling · · ✓
SDArthralgia · · ✓
SDHeadache · · ✓
SDLoss of personal independence in daily activities · · ✓
SDMyalgia · · ✓
SDThroat irritation · · ✓
SROAdverse reaction · · ✓
SROHeadache · · ✓
SROInjection site pain · · ✓
SRONeck pain · · ✓
SROPain in extremity · · ✓

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