3XK-29867-67030
2 vaccinations
4 coded responses
21 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 982 / WA
- Registered
- 2020-12-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-26
Dose 1 — Moderna
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2020-12-28
Registered in v-safe
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2020-12-28
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
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2020-12-30
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling, Itching · NoneAdult check-in
- 2020-12-31
- 2021-01-01
- 2021-01-02
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2021-01-16
Survey response — day 21, dose 1MedDRA: Injection site erythema, Injection site pain, Injection site pruritus, Injection site rash — Feeling: GoodFree text: Around Jan.4, approx. 4 in. red rash & itching developed at site, lasting approx. 3-4 days. Resolved. Jan. 13 noticed muscle, at site, tender during pushups. Since resolved. Ok today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-23
Dose 2 — Moderna
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2021-01-24
Survey response — days 1–6 daily, dose 2MedDRA: Influenza like illness — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Horrendous flu like sx. Feels like GI maybe coming on.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-25
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-01-26
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling, Itching · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-01-27
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Itching · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-01-28
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Itching · Headache, Fatigue or tirednessAdult check-in
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2021-01-29
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
- 2021-01-30
- 2021-02-06
- 2021-02-13
- 2021-02-20
- 2021-02-27
- 2021-03-06
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2021-04-24
Survey response — 3 months, dose 2MedDRA: Asthenia, Diarrhoea, Dizziness, Headache, Plantar fasciitis — Feeling: Good · Be unable to work, Be unable to do your normal daily activitiesFree text: Other than onset of Plantar fasciitis, ok up until last Wed. woke up very dizzy, had diarrhea for 5 hrs. Dizziness diminished over 2 days then had a headache. Felt very weak for those days then ok. Ok today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-24
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2022-01-23
Survey response — 12 months, dose 2MedDRA: Adverse reaction, Breast pain, Breast swelling, Muscle twitching, Pruritus, Pyrexia — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Had the booster on Nov. 30,2021. 9 hrs later had full sx's of 2nd vac. with 101.7 fever, plus breast aching, swelling & fullness,also urethral, clitoral twitching for 1+hrs. In the weeks since have had breast itching & aching.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-26 | Moderna | |
| 2 | 2021-01-23 | Moderna |
Free text
Release 2 — day 21, dose 1
Symptoms: Around Jan.4, approx. 4 in. red rash & itching developed at site, lasting approx. 3-4 days. Resolved. Jan. 13 noticed muscle, at site, tender during pushups. Since resolved. Ok today.
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Horrendous flu like sx. Feels like GI maybe coming on.
Release 7 — 3 months, dose 2
Symptoms: Other than onset of Plantar fasciitis, ok up until last Wed. woke up very dizzy, had diarrhea for 5 hrs. Dizziness diminished over 2 days then had a headache. Felt very weak for those days then ok. Ok today.
Release 11 — 12 months, dose 2
Symptoms: Had the booster on Nov. 30,2021. 9 hrs later had full sx's of 2nd vac. with 101.7 fever, plus breast aching, swelling & fullness,also urethral, clitoral twitching for 1+hrs. In the weeks since have had breast itching & aching.
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 | Adverse reaction | · | · | ✓ |
| SD | Asthenia | ✓ | ✓ | ✓ |
| SD | Breast pain | · | · | ✓ |
| SD | Breast swelling | · | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pain | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SD | Muscle twitching | · | · | ✓ |
| SD | Plantar fasciitis | ✓ | ✓ | ✓ |
| SD | Pruritus | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SRO | Influenza like illness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release