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4C2-29029-69010

2 vaccinations 7 coded responses 14 check-ins 7 free-text entries 0 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
640 / MO
Registered
2021-03-14
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-26
    Dose 1 — Moderna
  2. 2021-03-14
    Registered in v-safe
  3. 2021-03-14
    Health check-in — day 14, dose 1
    Feeling: Fair
    Adult check-in
  4. 2021-03-19
    Survey response — day 21, dose 1
    MedDRA: Injection site erythema, Injection site pruritus — Feeling: Good
    Free text: Slight redness and sporadic itching around injection site. Far from alarming.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-26
    Dose 2 — Moderna
  6. 2021-03-26
    Survey response — day 0, dose 2
    MedDRA: Attention deficit hyperactivity disorder, Disturbance in attention — Feeling: Good · Fever · Chills
    Free text: I question if I'm developing ADD
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-03-27
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Fever · Chills, Headache
    Adult check-in
  8. 2021-03-28
    Survey response — days 1–6 daily, dose 2
    MedDRA: Headache — Feeling: Fair · Fever · Chills, Headache
    Free text: Temp 99.0°F by p.m. hrs. Headache reduced to mild.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-03-29
    Survey response — days 1–6 daily, dose 2
    MedDRA: Chromaturia — Feeling: Fair · Site: Pain, Redness · Fever · Chills, Headache
    Free text: VERY dark urine since Sat 3/26. Also today I actually feel >Fair & <Good.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-03-31
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness, Itching · Chills
    Adult check-in
  11. 2021-04-02
    Survey response — day 7, dose 2
    MedDRA: Chromaturia — Feeling: Good · Chills
    Free text: Urine lighter than past, yet still darker than "normal ".
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-04-10
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-04-16
    Survey response — day 21, dose 2
    MedDRA: Feeling cold — Feeling: Good
    Free text: Lingering chilliness - I had a hard time keeping warm. The weather was pleasant, warm, and I wore a jacket in house and parked under my space heater.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-04-23
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-04-30
    Survey response — day 35, dose 2
    MedDRA: Fear, Palpitations — Feeling: Good · Be unable to do your normal daily activities
    Free text: STRONG erratic heart palpitations mid-week. Visible. Scary.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-05-08
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-06-28
    Health check-in — 3 months, dose 2
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-26Moderna
22021-03-26Moderna

Free text

Release 5 — day 21, dose 1

2021-03-19

Symptoms: Slight redness and sporadic itching around injection site. Far from alarming.

Release 6 — day 0, dose 2

2021-03-26

Systemic reaction (other): I question if I'm developing ADD

Release 6 — days 1–6 daily, dose 2

2021-03-28

Systemic reaction (other): Temp 99.0°F by p.m. hrs. Headache reduced to mild.

2021-03-29

Systemic reaction (other): VERY dark urine since Sat 3/26. Also today I actually feel >Fair & <Good.

Release 6 — day 7, dose 2

2021-04-02

Systemic reaction (other): Urine lighter than past, yet still darker than "normal ".

Release 7 — day 21, dose 2

2021-04-16

Symptoms: Lingering chilliness - I had a hard time keeping warm. The weather was pleasant, warm, and I wore a jacket in house and parked under my space heater.

Release 8 — day 35, dose 2

2021-04-30

Symptoms: STRONG erratic heart palpitations mid-week. Visible. Scary.

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

FieldPreferred term2021-092023-042024-11
SDFear ✓ ✓ ✓
SDFeeling cold ✓ ✓ ✓
SDInjection site erythema ✓ ✓ ✓
SDInjection site pruritus ✓ ✓ ✓
SDPalpitations ✓ ✓ ✓
SROAttention deficit hyperactivity disorder ○ ✓ ○
SROChromaturia ✓ ✓ ✓
SRODisturbance in attention ✓ · ✓
SROHeadache ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release