42C-19728-98341
3 vaccinations
4 coded responses
28 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 272 / NC
- Registered
- 2021-01-07
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
R3N-12093-87836
Child or adolescent in my care · Male · 2022-04-26
Timeline
-
2021-01-05
Dose 1 — Moderna
-
2021-01-07
Registered in v-safe
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-10
- 2021-01-11
- 2021-01-12
- 2021-01-19
- 2021-01-26
- 2021-02-02
-
2021-02-03
Dose 2 — Moderna
-
2021-02-04
Survey response — days 1–6 daily, dose 2MedDRA: Hypoaesthesia oral, Paraesthesia oral — Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activitiesFree text: Tingly numb lipsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-05
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness · Fatigue or tirednessAdult check-in
-
2021-02-06
Survey response — days 1–6 daily, dose 2MedDRA: Feeling abnormal — Feeling: Good · HeadacheFree text: Slight brain fog.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-07
- 2021-02-09
- 2021-02-11
- 2021-02-17
- 2021-02-24
- 2021-03-03
- 2021-03-10
-
2021-03-17
Survey response — day 42, dose 2MedDRA: Cough, Respiratory tract congestion, Spinal pain, Vertigo — Feeling: Fair · Be unable to workFree text: Cough congestion vertigoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-08
- 2021-08-04
-
2022-02-03
Survey response — 12 months, dose 2MedDRA: COVID-19, Type 2 diabetes mellitus — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Type 2 Diabetes, I also had Covid twiceMedDRA releases: 2024-11 · check-in free text available
-
2022-02-03
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · 1 call case(s)
-
2022-02-04
Call successfulDoes not wish to fill out VAERS report
-
2022-03-17
Dose 3 — Pfizer-BioNTech
- 2022-04-26
- 2022-04-28
- 2022-06-16
- 2022-09-17
- 2023-03-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-05 | Moderna | |
| 2 | 2021-02-03 | Moderna | |
| 3 | 2022-03-17 | Pfizer-BioNTech | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-02-03 | Successful 2022-02-04 |
Does not wish to fill out VAERS report |
Free text
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Tingly numb lips
Systemic reaction (other): Slight brain fog.
Release 5 — day 42, dose 2
Symptoms: Cough congestion vertigo
Release 11 — 12 months, dose 2
Symptoms: Type 2 Diabetes, I also had Covid twice
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 | Cough | ✓ | ✓ | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SD | Spinal pain | ✓ | ✓ | ✓ |
| SD | Type 2 diabetes mellitus | · | · | ✓ |
| SD | Vertigo | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Hypoaesthesia oral | ✓ | ✓ | ✓ |
| SRO | Paraesthesia oral | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release