3Z2-42256-85516
4 vaccinations
4 coded responses
29 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 024 / MA
- Registered
- 2021-12-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-20
Dose 1 — Moderna
-
2021-05-21
Dose 2 — Moderna
-
2021-12-15
Registered in v-safe
-
2021-12-15
Dose 3 — Moderna
-
2021-12-15
Health check-in — day 0, dose 3Feeling: Fair · Site: Pain · Fever · Muscle or body achesAdult check-in
- 2021-12-17
-
2021-12-18
Survey response — days 1–6 daily, dose 3MedDRA: Chills, Headache, Injection site bruising, Injection site pain, Myalgia, Pyrexia — Feeling: Good · Fatigue or tirednessFree text: Bruising at the injection site today. On 12/16/21 had moderate/severe fever 101.9, moderate/severe headache, moderate chills, moderate muscle aches, moderate bruising/pain at injection site.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-19
Survey response — days 1–6 daily, dose 3MedDRA: Hypoaesthesia oral, Injection site bruising — Feeling: Good · Fatigue or tirednessFree text: Bruising at injection site today. Forgot to report on 12/15 approx 3 hrs after vaccination had some slight numbness around left side of mouthMedDRA releases: 2024-11 · check-in free text available
- 2021-12-20
- 2021-12-21
- 2021-12-22
-
2021-12-29
Survey response — day 14, dose 3MedDRA: Nasal congestion, Oropharyngeal pain — Feeling: GoodFree text: Mild Nasal congestion, mild sore throatMedDRA releases: 2024-11 · check-in free text available
- 2022-01-05
- 2022-01-12
- 2022-01-19
- 2022-01-26
- 2022-03-16
-
2022-06-16
Survey response — 6 months, dose 3MedDRA: SARS-CoV-2 test negative, Upper respiratory tract infection — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Upper respiratory infection 4/22-4/29, 5/31-6/4. Confirmed not covid by both rapid antigen and pcr tests both times.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-14
Dose 4 — Pfizer-BioNTech
- 2022-10-14
- 2022-10-15
- 2022-10-16
- 2022-10-17
- 2022-10-18
- 2022-10-19
- 2022-10-20
- 2022-10-21
- 2022-10-28
- 2022-11-04
- 2022-11-11
- 2022-11-18
- 2022-11-25
- 2023-01-13
- 2023-04-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-20 | Moderna | No |
| 2 | 2021-05-21 | Moderna | No |
| 3 | 2021-12-15 | Moderna | No |
| 4 | 2022-10-14 | Pfizer-BioNTech | No |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Bruising at the injection site today. On 12/16/21 had moderate/severe fever 101.9, moderate/severe headache, moderate chills, moderate muscle aches, moderate bruising/pain at injection site.
Systemic reaction (other): Bruising at injection site today. Forgot to report on 12/15 approx 3 hrs after vaccination had some slight numbness around left side of mouth
Release 10 — day 14, dose 3
Symptoms: Mild Nasal congestion, mild sore throat
Release 12 — 6 months, dose 3
Symptoms: Upper respiratory infection 4/22-4/29, 5/31-6/4. Confirmed not covid by both rapid antigen and pcr tests both times.
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 | Nasal congestion | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Hypoaesthesia oral | · | · | ✓ |
| SRO | Injection site bruising | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Myalgia | · | · | ✓ |
| SRO | Pyrexia | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release