48Q-64339-05960
2 vaccinations
3 coded responses
6 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 342 / FL
- Registered
- 2021-04-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-17
Dose 1 — Moderna
-
2021-04-14
Dose 2 — Moderna
-
2021-04-21
Registered in v-safe
-
2021-04-21
Survey response — day 7, dose 2MedDRA: Chills, Headache, Pyrexia — Feeling: FairFree text: I have had a variety of reactions since receiving the second vaccine. Starting at 10 pm on 4/14/21, I had aches, fever, chills and an unbelievable headache that continued for 24 hours. Since then I have had continued symptoms including a feverMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-29
Survey response — day 14, dose 2MedDRA: Dyspnoea, Fatigue, Nasopharyngitis, Oral herpes — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Fever blister, shortness of breath, cold symptoms, fatigueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-05
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2021-07-14
Survey response — 3 months, dose 2MedDRA: Ageusia, Cough, Dyspnoea, Productive cough, Respiratory disorder, Rhinorrhoea, Sneezing — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Upper respiratory issues difficulty breathing sometimes dry harsh cough, sometimes phlegm yellow to dark yellow. Sneezing, runny nose, loss of tasteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-07-14
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-22
-
2021-07-22
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-10-13
- 2022-04-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-17 | Moderna | |
| 2 | 2021-04-14 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 7 — day 7, dose 2
Systemic reaction (other): I have had a variety of reactions since receiving the second vaccine. Starting at 10 pm on 4/14/21, I had aches, fever, chills and an unbelievable headache that continued for 24 hours. Since then I have had continued symptoms including a fever
Release 8 — day 14, dose 2
Symptoms: Fever blister, shortness of breath, cold symptoms, fatigue
Release 9 — 3 months, dose 2
Symptoms: Upper respiratory issues difficulty breathing sometimes dry harsh cough, sometimes phlegm yellow to dark yellow. Sneezing, runny nose, loss of taste
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 | Ageusia | ✓ | ✓ | ✓ |
| SD | Anosmia | ○ | ○ | ○ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | ✓ | ✓ | ✓ |
| SD | Oral herpes | ✓ | ✓ | ✓ |
| SD | Productive cough | ✓ | ✓ | ✓ |
| SD | Respiratory disorder | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SD | Sneezing | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release