3Z3-21682-93457
2 vaccinations
5 coded responses
25 check-ins
5 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 926 / CA
- Registered
- 2021-01-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-22
Registered in v-safe
-
2021-01-22
Dose 1 — Moderna
- 2021-01-22
-
2021-01-23
Survey response — days 1–6 daily, dose 1MedDRA: Back pain — Feeling: Good · Site: PainFree text: Very mild back pain near kidney area may be unrelatedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-01-29
-
2021-02-05
Survey response — day 14, dose 1MedDRA: Diarrhoea, SARS-CoV-2 test negative — Feeling: GoodFree text: Had some diarrhea for a couple days but I know a couple other people that did too. Rapid Covid with Abbott negative.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-12
-
2021-02-19
Dose 2 — Moderna
-
2021-02-20
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Muscle or body achesAdult check-in
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-02-25
- 2021-02-26
- 2021-03-05
- 2021-03-12
- 2021-03-19
- 2021-03-26
-
2021-04-02
Survey response — day 42, dose 2MedDRA: Diarrhoea — Feeling: FairFree text: Diarrhea today two timesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-21
-
2021-08-22
Survey response — 6 months, dose 2MedDRA: Gastrointestinal disorder, Headache, Nervousness, Upper respiratory tract infection — Feeling: GoodFree text: Have had an URI once, GI symptoms a couple times and a headache a couple times. Always nervous it could be Covid since plenty of vaccinated people are catching it.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2022-02-21
Survey response — 12 months, dose 2MedDRA: COVID-19, Influenza like illness, Malaise, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Had the flu type symptoms (Covid negative per 3 antigen and 1 PCR test) in early January. Had Covid in late January. Symptoms moderate 3-4 days then very mild. No residual.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-22 | Moderna | |
| 2 | 2021-02-19 | Moderna |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Very mild back pain near kidney area may be unrelated
Release 3 — day 14, dose 1
Symptoms: Had some diarrhea for a couple days but I know a couple other people that did too. Rapid Covid with Abbott negative.
Release 6 — day 42, dose 2
Symptoms: Diarrhea today two times
Release 9 — 6 months, dose 2
Symptoms: Have had an URI once, GI symptoms a couple times and a headache a couple times. Always nervous it could be Covid since plenty of vaccinated people are catching it.
Release 11 — 12 months, dose 2
Symptoms: Had the flu type symptoms (Covid negative per 3 antigen and 1 PCR test) in early January. Had Covid in late January. Symptoms moderate 3-4 days then very mild. No residual.
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 | COVID-19 | · | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Gastrointestinal disorder | ✓ | · | ✓ |
| SD | Headache | ✓ | · | ✓ |
| SD | Influenza like illness | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Nervousness | ✓ | · | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SD | Upper respiratory tract infection | ✓ | · | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release