3XA-16317-91307
5 vaccinations
4 coded responses
49 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 300 / GA
- Registered
- 2021-01-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-12
Registered in v-safe
-
2021-01-12
Dose 1 — Moderna
- 2021-01-12
-
2021-01-13
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-26
- 2021-02-02
- 2021-02-09
-
2021-02-13
Dose 2 — Moderna
- 2021-02-13
-
2021-02-14
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to workAdult check-in
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-02-27
-
2021-03-06
Survey response — day 21, dose 2MedDRA: Facial pain, Fatigue — Feeling: FairFree text: Fatigue. Have chalked it up to a coincidence. For past month have had facial pain radiating from left cheekbone. Visit to doctor this week. They want to rule out sinus cyst or trigeminal nerve issue. Have dental appointment upcoming.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-13
- 2021-03-20
- 2021-03-27
- 2021-05-15
-
2021-08-14
Survey response — 6 months, dose 2MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: FairFree text: Cold symptoms after air travel on August 5. Had a negative result on PCR test administered on Tuesday August 10.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-11-01
Dose 3 — Moderna
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-05
- 2021-11-06
- 2021-11-07
- 2021-11-17
- 2021-11-23
- 2021-11-29
- 2021-12-08
- 2021-12-15
- 2022-02-01
-
2022-04-13
Dose 4 — Moderna
-
2022-04-19
Survey response — days 1–6 daily, dose 4MedDRA: Fatigue, Malaise, Pain in extremity — Feeling: GoodFree text: The day after receiving the booster I felt unwell and tired. My arm was sore for about three day.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-20
- 2022-04-27
- 2022-05-04
- 2022-05-11
- 2022-05-18
- 2022-05-25
- 2022-07-13
-
2022-10-12
Survey response — 6 months, dose 4MedDRA: COVID-19 — Feeling: Good · Be unable to do your normal daily activitiesFree text: CovidMedDRA releases: 2024-11 · check-in free text available
-
2022-11-22
Dose 5 — Moderna
- 2023-05-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-12 | Moderna | |
| 2 | 2021-02-13 | Moderna | |
| 3 | 2021-11-01 | Moderna | No |
| 4 | 2022-04-13 | Moderna | No |
| 5 | 2022-11-22 | Moderna | No |
Free text
Release 5 — day 21, dose 2
Symptoms: Fatigue. Have chalked it up to a coincidence. For past month have had facial pain radiating from left cheekbone. Visit to doctor this week. They want to rule out sinus cyst or trigeminal nerve issue. Have dental appointment upcoming.
Release 9 — 6 months, dose 2
Symptoms: Cold symptoms after air travel on August 5. Had a negative result on PCR test administered on Tuesday August 10.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): The day after receiving the booster I felt unwell and tired. My arm was sore for about three day.
Release 12 — 6 months, dose 4
Symptoms: Covid
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 |
|---|---|---|---|---|
| SD | COVID-19 | · | · | ✓ |
| SD | Facial pain | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | ✓ | · | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Malaise | · | · | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release