4BM-21247-11805
5 vaccinations
9 coded responses
33 check-ins
8 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 875 / NM
- Registered
- 2021-03-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-05
Dose 1 — Moderna
-
2021-03-06
Registered in v-safe
-
2021-03-06
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: Fair · Site: Pain · Fatigue or tiredness, DiarrheaFree text: NoneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-12
- 2021-03-19
- 2021-03-26
-
2021-04-02
Dose 2 — Moderna
- 2021-04-02
-
2021-04-03
Survey response — days 1–6 daily, dose 2MedDRA: Injection site warmth — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Arm is warm at injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-04
Survey response — days 1–6 daily, dose 2MedDRA: Injection site warmth — Feeling: Fair · Fever · Fatigue or tirednessFree text: Arm is still warm at injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-05
Survey response — days 1–6 daily, dose 2MedDRA: Injection site warmth — Feeling: Fair · Fatigue or tiredness, DiarrheaFree text: Arm is still a bit warm at injection site!MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-09
-
2021-04-16
Survey response — day 14, dose 2MedDRA: Pyrexia — Feeling: GoodFree text: I think I mentioned on the last check-in of a low-grade fever 4 or 5 days post-vax. It happened again a day or two later -- pppfffft!! But have been feeling fine since :-)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-05-14
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2021-07-02
Survey response — 3 months, dose 2MedDRA: Abdominal discomfort, Fatigue — Feeling: FairFree text: Tummy upset and fatigue.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-10-01
Survey response — 6 months, dose 2MedDRA: Cough, Oral pain, Oropharyngeal pain, SARS-CoV-2 test negative, Sinus congestion — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Sinus congestion, painful tonsils and soft palate, wet cough. Second episode the same except no cough. Two PCR covid tests came back negative.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-26
Dose 3 — Moderna
- 2022-04-02
-
2022-04-28
Dose 4 — Pfizer-BioNTech
- 2022-06-01
-
2022-10-10
Dose 5 — Moderna
- 2022-10-25
- 2022-10-31
- 2022-11-07
-
2022-11-14
Survey response — day 35, dose 5MedDRA: Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative, Sneezing — Feeling: GoodFree text: Congestion, sneezing, runny nose. Multiple at-home COVID tests were negative.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-21
-
2023-01-09
Survey response — 3 months, dose 5MedDRA: Ear discomfort, Ear pain, Sinus congestion — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitMedDRA releases: 2024-11
-
2023-01-09
Report sent to call center — 3 months, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2023-01-10
- 2023-04-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-05 | Moderna | |
| 2 | 2021-04-02 | Moderna | |
| 3 | 2021-11-26 | Moderna | No |
| 4 | 2022-04-28 | Pfizer-BioNTech | No |
| 5 | 2022-10-10 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): None
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Arm is warm at injection site.
Systemic reaction (other): Arm is still warm at injection site
Systemic reaction (other): Arm is still a bit warm at injection site!
Release 7 — day 14, dose 2
Symptoms: I think I mentioned on the last check-in of a low-grade fever 4 or 5 days post-vax. It happened again a day or two later -- pppfffft!! But have been feeling fine since :-)
Release 9 — 3 months, dose 2
Symptoms: Tummy upset and fatigue.
Release 9 — 6 months, dose 2
Symptoms: Sinus congestion, painful tonsils and soft palate, wet cough. Second episode the same except no cough. Two PCR covid tests came back negative.
Release 12 — day 35, dose 5
Symptoms: Congestion, sneezing, runny nose. Multiple at-home COVID tests were 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 |
|---|---|---|---|---|
| SD | Abdominal discomfort | ✓ | ✓ | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Ear discomfort | · | · | ✓ |
| SD | Ear pain | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Oral pain | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SRO | Injection site warmth | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release