3XZ-10163-61118
2 vaccinations
9 coded responses
26 check-ins
9 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 507 / IA
- Registered
- 2021-02-11
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-11
Registered in v-safe
-
2021-02-11
Dose 1 — Moderna
- 2021-02-11
- 2021-02-12
- 2021-02-13
-
2021-02-14
Survey response — days 1–6 daily, dose 1MedDRA: Insomnia — Feeling: Good · Site: SwellingFree text: Trouble getting to sleep last night. I dont know if its related or not. Couldnt get to sleep till three this morningMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-15
- 2021-02-16
-
2021-02-17
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection siteAdult check-in
-
2021-02-18
Survey response — day 7, dose 1MedDRA: Rash — Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection siteFree text: As I indicated yesterday I dont know if the rash is from Covid or something else it is on my right handMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-25
- 2021-03-04
-
2021-03-11
Dose 2 — Moderna
- 2021-03-11
-
2021-03-12
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pain — Feeling: Good · Muscle or body achesFree text: But pain is in the shot areaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-13
-
2021-03-14
Survey response — days 1–6 daily, dose 2MedDRA: Axillary pain — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Pain has been under my left arm pitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-25
-
2021-04-01
Survey response — day 21, dose 2MedDRA: Chills, Eye pruritus, Feeling cold, Self-medication — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Quite a bit of itchy eyes , moments of feeling cold (different from usual chills which I rarely get). Stuffy nasal and coughing. I couldnt tell if it its from the shot or if I was getting a cold or suffering from allergies. I took Tylenol c. SyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-08
Survey response — day 28, dose 2MedDRA: Cough, Nasal congestion — Feeling: Good · Be unable to do your normal daily activitiesFree text: Very congested nostrils, some coughing; However now betterMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-15
- 2021-04-22
-
2021-06-10
Survey response — 3 months, dose 2MedDRA: Depressed mood, Fatigue, Restlessness — Feeling: GoodFree text: My sleep at night seems unpleasant. Meaning when I wake up my body feels bogged down. I also am more restless in general. This could be from so many days of unemployment.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-09-10
Survey response — 6 months, dose 2MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Tired at timesMedDRA releases: 2024-11 · check-in free text available
-
2022-03-13
Survey response — 12 months, dose 2MedDRA: Chills, Cough, Fatigue, Viral infection — Feeling: Good · Be unable to do your normal daily activitiesFree text: Very bad chills, tired, cough; I believe I had a virus. I have taken one test since then and it was negative.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-11 | Moderna | |
| 2 | 2021-03-11 | Moderna |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Trouble getting to sleep last night. I dont know if its related or not. Couldnt get to sleep till three this morning
Release 4 — day 7, dose 1
Systemic reaction (other): As I indicated yesterday I dont know if the rash is from Covid or something else it is on my right hand
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): But pain is in the shot area
Systemic reaction (other): Pain has been under my left arm pit
Release 6 — day 21, dose 2
Symptoms: Quite a bit of itchy eyes , moments of feeling cold (different from usual chills which I rarely get). Stuffy nasal and coughing. I couldnt tell if it its from the shot or if I was getting a cold or suffering from allergies. I took Tylenol c. Sy
Release 7 — day 28, dose 2
Symptoms: Very congested nostrils, some coughing; However now better
Release 9 — 3 months, dose 2
Symptoms: My sleep at night seems unpleasant. Meaning when I wake up my body feels bogged down. I also am more restless in general. This could be from so many days of unemployment.
Release 9 — 6 months, dose 2
Symptoms: Tired at times
Release 11 — 12 months, dose 2
Symptoms: Very bad chills, tired, cough; I believe I had a virus. I have taken one test since then and it was negative.
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 | Chills | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Depressed mood | ✓ | ✓ | ✓ |
| SD | Eye pruritus | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Feeling cold | ✓ | ✓ | ✓ |
| SD | Nasal congestion | ✓ | ✓ | ✓ |
| SD | Restlessness | ✓ | ✓ | ✓ |
| SD | Self-medication | ✓ | ✓ | ✓ |
| SD | Viral infection | · | · | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Insomnia | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release