46R-21282-07425
4 vaccinations
8 coded responses
54 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 600 / IL
- Registered
- 2021-01-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-30
Registered in v-safe
-
2021-01-30
Dose 1 — Moderna
-
2021-01-30
Survey response — day 0, dose 1MedDRA: Photophobia — Feeling: Fair · Site: Pain · Fatigue or tirednessFree text: Sensitivity to lights (they seem brighter)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-05
-
2021-02-06
Survey response — day 7, dose 1MedDRA: Injection site erythema — Feeling: Good · Site: RednessFree text: The redness mentioned above appeared near injection site one week after injection, seems consistent with "COVID armMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-13
Survey response — day 14, dose 1MedDRA: Immunisation reaction, Injection site rash — Feeling: GoodFree text: I reported last time that I developed the COVID arm rash at injection site one week after my first dose. The rash grew in size and has lasted a week. It has almost faded now.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-20
-
2021-02-27
Dose 2 — Moderna
- 2021-02-27
-
2021-02-28
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: That fever of 100.3 is high for me since I am often in the 97sMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-01
Survey response — days 1–6 daily, dose 2MedDRA: Epistaxis — Feeling: Good · Site: Pain, RednessFree text: Had a bad nosebleed. I am prone to them in winter though haven't had one this season yet. Probably unrelated to vaccine but will see if I get anymoreMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-13
- 2021-03-20
- 2021-03-27
- 2021-04-03
- 2021-04-10
- 2021-05-29
- 2021-08-28
-
2021-10-28
Dose 3 — Moderna
- 2021-10-28
-
2021-10-29
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
- 2021-10-30
-
2021-10-31
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Redness, Itching · NoneAdult check-in
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-11
- 2021-11-18
- 2021-11-25
- 2021-12-02
- 2021-12-09
- 2022-01-27
- 2022-04-28
-
2022-09-10
Dose 4 — Moderna
- 2022-09-10
-
2022-09-11
Survey response — days 1–6 daily, dose 4MedDRA: Body temperature increased — Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: My fever of 100.2 was high for me as I am normally in the mid to high 97sMedDRA releases: 2024-11 · check-in free text available
- 2022-09-12
- 2022-09-13
- 2022-09-15
-
2022-09-16
Survey response — days 1–6 daily, dose 4MedDRA: Fatigue, Feeling hot, SARS-CoV-2 test negative — Feeling: Fair · Fever · Fatigue or tirednessFree text: Feel feverish but no temperature. Feel tired and "off". May all be hormonal, but I don't know. Rapid COVID test negativeMedDRA releases: 2024-11 · check-in free text available
- 2022-09-17
- 2022-09-24
- 2022-10-01
- 2022-10-08
- 2022-10-15
- 2022-10-22
- 2022-12-10
-
2023-03-11
Survey response — 6 months, dose 4MedDRA: Hypertension, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
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2023-03-11
Report sent to call center — 6 months, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2023-03-13
- 2023-03-14
-
2023-03-22
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-30 | Moderna | |
| 2 | 2021-02-27 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
| 4 | 2022-09-10 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 3 — day 0, dose 1
Systemic reaction (other): Sensitivity to lights (they seem brighter)
Release 3 — day 7, dose 1
Systemic reaction (other): The redness mentioned above appeared near injection site one week after injection, seems consistent with "COVID arm
Release 4 — day 14, dose 1
Symptoms: I reported last time that I developed the COVID arm rash at injection site one week after my first dose. The rash grew in size and has lasted a week. It has almost faded now.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): That fever of 100.3 is high for me since I am often in the 97s
Systemic reaction (other): Had a bad nosebleed. I am prone to them in winter though haven't had one this season yet. Probably unrelated to vaccine but will see if I get anymore
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): My fever of 100.2 was high for me as I am normally in the mid to high 97s
Systemic reaction (other): Feel feverish but no temperature. Feel tired and "off". May all be hormonal, but I don't know. Rapid COVID test negative
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 |
|---|---|---|---|---|
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Hypertension | · | · | ✓ |
| SD | Immunisation reaction | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SRO | Body temperature increased | · | · | ✓ |
| SRO | Epistaxis | ✓ | ✓ | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Feeling hot | · | · | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Photophobia | ✓ | ✓ | ✓ |
| SRO | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release