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
-
2021-03-24
Dose 1 — Moderna
-
2021-04-20
Registered in v-safe
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2021-04-20
Survey response — day 21, dose 1MedDRA: Asthma, Cough, Nasopharyngitis, Pre-existing disease, Rhinorrhoea, Throat irritation, Wheezing — Feeling: FairFree 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
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2021-04-21
Dose 2 — Moderna
- 2021-04-21
-
2021-04-22
Survey response — days 1–6 daily, dose 2MedDRA: 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 activitiesFree text: Wheezing, cough, running noseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-28
Survey response — day 7, dose 2MedDRA: Cough, Pre-existing disease — Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Cough, asthmaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-07
- 2021-05-12
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2021-05-28
Survey response — day 35, dose 2MedDRA: Rash, Rash pruritic — Feeling: FairFree text: Itchy bumpy Rash on forearms for the last 7 days that not going awayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-04
- 2021-10-22
-
2021-10-26
Dose 3 — Moderna
-
2021-11-02
Health check-in — day 7, dose 3Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-11-23
- 2021-11-30
- 2021-12-07
-
2022-01-27
Survey response — 3 months, dose 3MedDRA: Condition aggravated, Cough, Nasal dryness, Pre-existing disease, Rhinorrhoea, Sensitivity to weather change — Feeling: GoodFree 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
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2022-04-06
Dose 4 — Moderna
- 2022-04-19
- 2022-04-25
- 2022-04-27
- 2022-05-04
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2022-05-18
Survey response — day 42, dose 4MedDRA: Herpes simplex — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree 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
-
2022-05-18
Report sent to call center — day 42, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-05-19
- 2022-07-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-24 | Moderna | |
| 2 | 2021-04-21 | Moderna | |
| 3 | 2021-10-26 | Moderna | No |
| 4 | 2022-04-06 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 7 — day 21, dose 1
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
Systemic reaction (other): Wheezing, cough, running nose
Release 8 — day 7, dose 2
Systemic reaction (other): Cough, asthma
Release 8 — day 35, dose 2
Symptoms: Itchy bumpy Rash on forearms for the last 7 days that not going away
Release 11 — 3 months, dose 3
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
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Asthma | ✓ | ✓ | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Herpes simplex | · | · | ✓ |
| SD | Nasal dryness | · | · | ✓ |
| SD | Nasopharyngitis | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rash pruritic | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SD | Sensitivity to weather change | · | · | ✓ |
| SD | Throat irritation | ✓ | ✓ | ✓ |
| SD | Wheezing | ✓ | ✓ | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Rhinorrhoea | ✓ | ✓ | ✓ |
| SRO | Sneezing | ✓ | ✓ | ✓ |
| SRO | Wheezing | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release