3YZ-12809-36313
4 vaccinations
7 coded responses
31 check-ins
7 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 986 / WA
- Registered
- 2021-02-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-03
Dose 1 — Moderna
-
2021-02-04
Registered in v-safe
-
2021-02-04
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, NauseaAdult check-in
- 2021-02-05
-
2021-02-06
Survey response — days 1–6 daily, dose 1MedDRA: Abdominal discomfort — Feeling: Fair · Headache, Fatigue or tirednessFree text: Mild stomach upset. It may or may not be related to the vaccination.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-17
- 2021-02-24
-
2021-03-03
Dose 2 — Moderna
- 2021-03-03
-
2021-03-04
Survey response — days 1–6 daily, dose 2MedDRA: Herpes zoster — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activitiesFree text: I have just been diagnosed with mild herpes zoster, which may or may not contribute to my symptoms.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-06
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue, Headache, Pain, Pyrexia — Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection siteFree text: I missed my report-in yesterday. I had a fever as high as 100.6, headache, fatigue, and pain, all mild to moderate. My highest temp today was 99.0, but now is 98.4.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-03-31
-
2021-04-07
Survey response — day 35, dose 2MedDRA: Rhinorrhoea, Seasonal allergy, Sneezing — Feeling: GoodFree text: Seasonal allergies, mild sneezing and runny nose that responds to antihistamines.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-14
- 2021-06-02
-
2021-09-01
Survey response — 6 months, dose 2MedDRA: Abdominal discomfort, Sneezing — Feeling: GoodFree text: Some very occasional sneezing and an episode of mild digestive discomfort.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-10-28
Dose 3 — Moderna
-
2022-04-08
Dose 4 — Pfizer-BioNTech
-
2022-04-25
Survey response — day 14, dose 4MedDRA: Fatigue, Headache, Immunisation reaction, Pain, Pyrexia — Feeling: Good · Be unable to do your normal daily activitiesFree text: Reaction to Pfizer booster: headache, body aches, mild fever, fatigue for 1 day.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-01
- 2022-05-08
- 2022-05-13
-
2022-05-20
Survey response — day 42, dose 4MedDRA: Cough, Fatigue, Sneezing — Feeling: GoodFree text: Sneezing, coughing, fatigue, all mild symptoms.MedDRA releases: 2024-11 · check-in free text available
- 2022-07-08
- 2022-10-08
- 2023-04-08
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-03 | Moderna | |
| 2 | 2021-03-03 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
| 4 | 2022-04-08 | Pfizer-BioNTech | No |
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Mild stomach upset. It may or may not be related to the vaccination.
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): I have just been diagnosed with mild herpes zoster, which may or may not contribute to my symptoms.
Systemic reaction (other): I missed my report-in yesterday. I had a fever as high as 100.6, headache, fatigue, and pain, all mild to moderate. My highest temp today was 99.0, but now is 98.4.
Release 7 — day 35, dose 2
Symptoms: Seasonal allergies, mild sneezing and runny nose that responds to antihistamines.
Release 9 — 6 months, dose 2
Symptoms: Some very occasional sneezing and an episode of mild digestive discomfort.
Release 11 — day 14, dose 4
Symptoms: Reaction to Pfizer booster: headache, body aches, mild fever, fatigue for 1 day.
Release 11 — day 42, dose 4
Symptoms: Sneezing, coughing, fatigue, all mild symptoms.
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 | Abdominal discomfort | ✓ | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Immunisation reaction | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SD | Seasonal allergy | ✓ | ✓ | ✓ |
| SD | Sneezing | ✓ | ✓ | ✓ |
| SRO | Abdominal discomfort | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Herpes zoster | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release