3YB-91689-44418
5 vaccinations
7 coded responses
40 check-ins
7 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 972 / OR
- Registered
- 2021-03-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-10
Registered in v-safe
-
2021-03-10
Dose 1 — Moderna
- 2021-03-10
- 2021-03-11
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
-
2021-03-24
Survey response — day 14, dose 1MedDRA: Injection site pruritus, Injection site rash — Feeling: GoodFree text: The evening of March 18th, I developed itching and a rash on my right arm at the injection site. The rash was about 6 down my arm & 4 wide. Not raised or swollen. The itching stopped by morning; the rash is almost gone.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-31
-
2021-04-07
Dose 2 — Moderna
-
2021-04-07
Survey response — day 0, dose 2MedDRA: Unevaluable event — Feeling: GoodFree text: FYI I received my shot 10 min bfore this health checkMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-08
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-09
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-10
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Redness · Nausea, Abdominal painAdult check-in
-
2021-04-11
Survey response — days 1–6 daily, dose 2MedDRA: Body temperature abnormal, Hyperhidrosis — Feeling: Fair · Site: Redness · Fatigue or tiredness, NauseaFree text: My temperature regulation seems off; I start sweating for no good reason.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-12
- 2021-04-13
- 2021-04-14
- 2021-04-21
- 2021-04-28
- 2021-05-05
- 2021-05-12
- 2021-05-19
- 2021-07-07
- 2021-10-06
-
2021-11-19
Dose 3 — Moderna
-
2022-04-07
Survey response — 12 months, dose 2MedDRA: Emergency care, Flank pain, Nephrolithiasis — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: I went to the ER 2/26/22 for pain in my left flank- diagnosis of a 7mm kidney stone. I passed it 3/8/22. Followup ultrasound showed all OK.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-07
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
-
2022-04-12
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-04-13
Dose 4 — Moderna
- 2022-04-26
- 2022-04-27
- 2022-05-04
- 2022-05-11
-
2022-05-18
Survey response — day 35, dose 4MedDRA: Back pain, Cystitis, Micturition urgency — Feeling: FairFree text: I suspect I am coming down with a bladder infection this afternoon. I feel urgency and minor pain in my lower back. I will see if it worsens over the next few hours & seek medical care if necessary.MedDRA releases: 2024-11 · check-in free text available
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2022-05-25
Survey response — day 42, dose 4MedDRA: Blood urine present, Dysuria, Micturition urgency, Urinary tract infection — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: I developed a Urinary Tract Infection on 5/18/22. Typical symptoms- urgency, pain on urination, blood in urine.MedDRA releases: 2024-11 · check-in free text available
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2022-05-25
Report sent to call center — day 42, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-05-26
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-07-13
-
2022-10-04
Dose 5 — Pfizer-BioNTechCo-administered: Flu
-
2022-10-12
Survey response — 6 months, dose 4MedDRA: Cataract operation, Eye operation — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: I had cataract surgery on my left eye. No relation to vaccine! · Healthcare visit (other): Eye surgeryMedDRA releases: 2024-11 · check-in free text available
-
2022-10-12
Report sent to call center — 6 months, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2022-10-13
- 2022-10-19
- 2022-10-25
- 2022-11-01
- 2022-11-08
- 2022-11-15
- 2023-01-03
- 2023-04-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-10 | Moderna | |
| 2 | 2021-04-07 | Moderna | |
| 3 | 2021-11-19 | Moderna | No |
| 4 | 2022-04-13 | Moderna | No |
| 5 | 2022-10-04 | Pfizer-BioNTech | Flu |
Call center
3 call center cases
2 successful · 1 unsuccessful
Free text
Release 6 — day 14, dose 1
Symptoms: The evening of March 18th, I developed itching and a rash on my right arm at the injection site. The rash was about 6 down my arm & 4 wide. Not raised or swollen. The itching stopped by morning; the rash is almost gone.
Release 7 — day 0, dose 2
Systemic reaction (other): FYI I received my shot 10 min bfore this health check
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): My temperature regulation seems off; I start sweating for no good reason.
Release 11 — 12 months, dose 2
Symptoms: I went to the ER 2/26/22 for pain in my left flank- diagnosis of a 7mm kidney stone. I passed it 3/8/22. Followup ultrasound showed all OK.
Release 11 — day 35, dose 4
Symptoms: I suspect I am coming down with a bladder infection this afternoon. I feel urgency and minor pain in my lower back. I will see if it worsens over the next few hours & seek medical care if necessary.
Release 11 — day 42, dose 4
Symptoms: I developed a Urinary Tract Infection on 5/18/22. Typical symptoms- urgency, pain on urination, blood in urine.
Release 12 — 6 months, dose 4
Symptoms: I had cataract surgery on my left eye. No relation to vaccine!
Healthcare visit (other): Eye surgery
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 | Eye operation | · | · | ✓ |
| SD | Back pain | · | · | ✓ |
| SD | Blood urine present | · | · | ✓ |
| SD | Cataract operation | · | · | ✓ |
| SD | Cystitis | · | · | ✓ |
| SD | Dysuria | · | · | ✓ |
| SD | Emergency care | · | · | ✓ |
| SD | Flank pain | · | · | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SD | Micturition urgency | · | · | ✓ |
| SD | Nephrolithiasis | · | · | ✓ |
| SD | Urinary tract infection | · | · | ✓ |
| SRO | Body temperature abnormal | ✓ | ✓ | ✓ |
| SRO | Hyperhidrosis | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release