46X-12963-44951
4 vaccinations
17 coded responses
45 check-ins
16 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 934 / CA
- Registered
- 2021-01-24
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
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2021-01-20
Dose 1 — Moderna
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2021-01-24
Registered in v-safe
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2021-01-24
Survey response — days 1–6 daily, dose 1MedDRA: Headache — Feeling: Good · HeadacheFree text: Mild intermittent infrequent headacheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-25
Survey response — days 1–6 daily, dose 1MedDRA: Headache — Feeling: Good · HeadacheFree text: Infrequent short stinging headacheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-26
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2021-01-27
Survey response — day 7, dose 1MedDRA: Rash, Self-medication — Feeling: Good · Joint painsFree text: One day after injection possible mild fine rash Abd took Benadryl 25 mg x1MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-03
- 2021-02-10
- 2021-02-17
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2021-02-24
Dose 2 — Moderna
- 2021-02-24
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2021-02-25
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body achesFree text: Neck muscleMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-26
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-10
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2021-03-17
Survey response — day 21, dose 2MedDRA: Fatigue, Headache, Herpes zoster, Neck pain, Somnolence — Feeling: GoodFree text: Headache neck pain tired sleeping post shingles vaccination on March 13. Otherwise nothing from modernaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
- 2021-04-02
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2021-04-07
Survey response — day 42, dose 2MedDRA: Headache, Rash — Feeling: GoodFree text: Daily headaches new facial rashMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-26
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2021-08-25
Survey response — 6 months, dose 2MedDRA: Amnesia, Loss of personal independence in daily activities — Feeling: GoodFree text: Daily normal activity or function regimen temporarily memory loss. Has improvedMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-10-26
Dose 3 — Moderna
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2021-10-26
Survey response — day 0, dose 3MedDRA: Amnesia — Feeling: GoodFree text: Prior to vac #3 memory loss improvedMedDRA releases: 2024-11 · check-in free text available
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2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: Sleep disorder — Feeling: Good · Site: PainFree text: Slept hard last night maybe from boosterMedDRA releases: 2024-11 · check-in free text available
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2021-10-28
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-10-29
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2021-10-30
Survey response — days 1–6 daily, dose 3MedDRA: Parosmia — Feeling: GoodFree text: Always have smell of gas like several monthsMedDRA releases: 2024-11 · check-in free text available
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-09
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2021-11-16
Survey response — day 21, dose 3MedDRA: Abdominal pain upper, Body temperature increased, Chills, Vomiting — Feeling: FairFree text: 2 days ago severe upper abdominal pain with vomiting chills temp 99.2 lasting 24 hoursMedDRA releases: 2024-11 · check-in free text available
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2021-11-23
Survey response — day 28, dose 3MedDRA: Cough, Dyspnoea — Feeling: GoodFree text: Mild sob with intermittent dry coughMedDRA releases: 2024-11 · check-in free text available
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2021-11-30
Survey response — day 35, dose 3MedDRA: Cough, Dyspnoea, Productive cough — Feeling: GoodFree text: Mild shortness breath dry and productive cough no feverMedDRA releases: 2024-11 · check-in free text available
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2021-12-07
Survey response — day 42, dose 3MedDRA: Cough, Diarrhoea, Vomiting — Feeling: FairFree text: Vomited diarrhea today. Cough persistsMedDRA releases: 2024-11 · check-in free text available
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2022-01-25
Survey response — 3 months, dose 3MedDRA: Oropharyngeal pain, Rhinorrhoea, Upper-airway cough syndrome — Feeling: GoodFree text: Sore throat post nasal drip runny noseMedDRA releases: 2024-11 · check-in free text available
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2022-04-02
Dose 4 — Moderna
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2022-04-14
Survey response — day 7, dose 4MedDRA: Fatigue, Headache, Pain — Feeling: GoodFree text: Headache body ache fatigue 4 days after last boosterMedDRA releases: 2024-11 · check-in free text available
- 2022-04-16
- 2022-04-23
- 2022-04-30
- 2022-05-07
- 2022-05-14
- 2022-07-02
- 2022-10-01
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2023-04-02
Survey response — 12 months, dose 4MedDRA: Memory impairment, Oropharyngeal pain — Feeling: GoodMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-20 | Moderna | |
| 2 | 2021-02-24 | Moderna | |
| 3 | 2021-10-26 | Moderna | No |
| 4 | 2022-04-02 | Moderna | No |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Mild intermittent infrequent headache
Systemic reaction (other): Infrequent short stinging headache
Release 2 — day 7, dose 1
Systemic reaction (other): One day after injection possible mild fine rash Abd took Benadryl 25 mg x1
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Neck muscle
Release 5 — day 21, dose 2
Symptoms: Headache neck pain tired sleeping post shingles vaccination on March 13. Otherwise nothing from moderna
Release 7 — day 42, dose 2
Symptoms: Daily headaches new facial rash
Release 9 — 6 months, dose 2
Symptoms: Daily normal activity or function regimen temporarily memory loss. Has improved
Release 10 — day 0, dose 3
Systemic reaction (other): Prior to vac #3 memory loss improved
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Slept hard last night maybe from booster
Systemic reaction (other): Always have smell of gas like several months
Release 10 — day 21, dose 3
Symptoms: 2 days ago severe upper abdominal pain with vomiting chills temp 99.2 lasting 24 hours
Release 10 — day 28, dose 3
Symptoms: Mild sob with intermittent dry cough
Release 10 — day 35, dose 3
Symptoms: Mild shortness breath dry and productive cough no fever
Release 10 — day 42, dose 3
Symptoms: Vomited diarrhea today. Cough persists
Release 11 — 3 months, dose 3
Symptoms: Sore throat post nasal drip runny nose
Release 11 — day 7, dose 4
Systemic reaction (other): Headache body ache fatigue 4 days after last booster
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 pain upper | · | · | ✓ |
| SD | Amnesia | ✓ | · | ✓ |
| SD | Body temperature increased | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Herpes zoster | ✓ | ✓ | ✓ |
| SD | Loss of personal independence in daily activities | ✓ | · | ✓ |
| SD | Memory impairment | · | · | ✓ |
| SD | Neck pain | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Productive cough | · | · | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Somnolence | ✓ | ✓ | ✓ |
| SD | Upper-airway cough syndrome | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Amnesia | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Parosmia | · | · | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Sleep disorder | · | · | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release