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3YH-10797-09047

4 vaccinations 6 coded responses 20 check-ins 6 free-text entries 1 call case
Sex
Female
Age at first dose
51-55
ZIP prefix
052 / VT
Registered
2021-04-20
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-24
    Dose 1 — Moderna
  2. 2021-04-20
    Registered in v-safe
  3. 2021-04-20
    Survey response — day 21, dose 1
    MedDRA: Asthma, Cough, Nasopharyngitis, Pre-existing disease, Rhinorrhoea, Throat irritation, Wheezing — Feeling: Fair
    Free text: My mild asthma that had been severe as a child, became severe again one week after the vaccine dose 1. In addition, Ive had consistent cold symptoms of a runny nose, scratchy throat, cough and wheezing.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-04-21
    Dose 2 — Moderna
  5. 2021-04-21
    Health check-in — day 0, dose 2
    Feeling: Fair · Nausea
    Adult check-in
  6. 2021-04-22
    Survey response — days 1–6 daily, dose 2
    MedDRA: Cough, Rhinorrhoea, Sneezing, Wheezing — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities
    Free text: Wheezing, cough, running nose
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-04-28
    Survey response — day 7, dose 2
    MedDRA: Cough, Pre-existing disease — Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Cough, asthma
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-05-07
    Health check-in — day 14, dose 2
    Feeling: Fair
    Adult check-in
  9. 2021-05-12
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  10. 2021-05-28
    Survey response — day 35, dose 2
    MedDRA: Rash, Rash pruritic — Feeling: Fair
    Free text: Itchy bumpy Rash on forearms for the last 7 days that not going away
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-06-04
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-10-22
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-10-26
    Dose 3 — Moderna
  14. 2021-11-02
    Health check-in — day 7, dose 3
    Feeling: Good · Rash, not including the immediate area around the injection site
    Adult check-in
  15. 2021-11-23
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  16. 2021-11-30
    Health check-in — day 35, dose 3
    Feeling: Fair
    Adult check-in
  17. 2021-12-07
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  18. 2022-01-27
    Survey response — 3 months, dose 3
    MedDRA: Condition aggravated, Cough, Nasal dryness, Pre-existing disease, Rhinorrhoea, Sensitivity to weather change — Feeling: Good
    Free text: Runny nose that gets dried out from the cold dry winter weather, some related coughs, intense migraine headaches that I've always had but they're more frequent now.
    MedDRA releases: 2024-11 · check-in free text available
  19. 2022-04-06
    Dose 4 — Moderna
  20. 2022-04-19
    Health check-in — day 7, dose 4
    Feeling: Good · Abdominal pain
    Adult check-in
  21. 2022-04-25
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  22. 2022-04-27
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  23. 2022-05-04
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  24. 2022-05-18
    Survey response — day 42, dose 4
    MedDRA: Herpes simplex — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: I've had a bout of herpes simplex trying to start at the tip inside of my nose and when I get that under control it tries to come out on my bottom lip edge.
    MedDRA releases: 2024-11 · check-in free text available
  25. 2022-05-18
    Report sent to call center — day 42, dose 4
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  26. 2022-05-19
  27. 2022-07-06
    Health check-in — 3 months, dose 4
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-24Moderna
22021-04-21Moderna
32021-10-26Moderna No
42022-04-06Moderna No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 7 — day 21, dose 1

2021-04-20

Symptoms: My mild asthma that had been severe as a child, became severe again one week after the vaccine dose 1. In addition, Ive had consistent cold symptoms of a runny nose, scratchy throat, cough and wheezing.

Release 7 — days 1–6 daily, dose 2

2021-04-22

Systemic reaction (other): Wheezing, cough, running nose

Release 8 — day 7, dose 2

2021-04-28

Systemic reaction (other): Cough, asthma

Release 8 — day 35, dose 2

2021-05-28

Symptoms: Itchy bumpy Rash on forearms for the last 7 days that not going away

Release 11 — 3 months, dose 3

2022-01-27

Symptoms: Runny nose that gets dried out from the cold dry winter weather, some related coughs, intense migraine headaches that I've always had but they're more frequent now.

Release 11 — day 42, dose 4

2022-05-18

Symptoms: I've had a bout of herpes simplex trying to start at the tip inside of my nose and when I get that under control it tries to come out on my bottom lip edge.

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
SDAsthma ✓ ✓ ✓
SDCondition aggravated · · ✓
SDCough ✓ ✓ ✓
SDHerpes simplex · · ✓
SDNasal dryness · · ✓
SDNasopharyngitis ✓ ✓ ✓
SDPre-existing disease ✓ ✓ ✓
SDRash ✓ ✓ ✓
SDRash pruritic ✓ ✓ ✓
SDRhinorrhoea ✓ ✓ ✓
SDSensitivity to weather change · · ✓
SDThroat irritation ✓ ✓ ✓
SDWheezing ✓ ✓ ✓
SROCough ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓
SRORhinorrhoea ✓ ✓ ✓
SROSneezing ✓ ✓ ✓
SROWheezing ✓ ✓ ✓

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