4CH-31660-18403
3 vaccinations
5 coded responses
18 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 120 / NY
- Registered
- 2021-01-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-18
Registered in v-safe
-
2021-01-18
Dose 1 — Moderna
- 2021-01-18
- 2021-01-21
- 2021-01-22
- 2021-01-23
- 2021-01-24
- 2021-01-25
-
2021-02-01
Survey response — day 14, dose 1MedDRA: Injection site erythema, Injection site pruritus, Injection site swelling — Feeling: GoodFree text: My injection site became red with swelling and itching about 8 days post to njectuon. Lasted 3 days then went awayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-08
-
2021-02-15
Dose 2 — Moderna
-
2021-02-22
Survey response — day 7, dose 2MedDRA: Chills, Fatigue, Headache — Feeling: Good · Site: PainFree text: The next day Feb 16 had chills off and on, headache off and on and feeling tired but very mildMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-01
- 2021-03-08
- 2021-03-16
- 2021-03-22
- 2021-03-29
- 2021-05-17
-
2021-08-16
Survey response — 6 months, dose 2MedDRA: Office visit, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Diagnosed with Sarcoidosis which actually started before vaccine so nothing to do with it · Healthcare visit (other): SpecialistsMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-16
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-12-06
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-12-12
Dose 3 — Moderna
-
2022-02-17
Survey response — 12 months, dose 2MedDRA: Condition aggravated, Pre-existing disease — Feeling: GoodFree text: Another uveitis flare up due to Sarcoidosis-no relation to vaccine , booster or CovidMedDRA releases: 2024-11 · check-in free text available
-
2022-12-12
Survey response — 12 months, dose 3MedDRA: COVID-19 — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Covid mild case in August On paxlovidMedDRA releases: 2024-11 · check-in free text available
-
2022-12-12
Report sent to call center — 12 months, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-12-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-18 | Moderna | |
| 2 | 2021-02-15 | Moderna | |
| 3 | 2021-12-12 | Moderna | No |
Call center
2 call center cases
1 successful · 1 unsuccessful
Free text
Release 3 — day 14, dose 1
Symptoms: My injection site became red with swelling and itching about 8 days post to njectuon. Lasted 3 days then went away
Release 4 — day 7, dose 2
Systemic reaction (other): The next day Feb 16 had chills off and on, headache off and on and feeling tired but very mild
Release 9 — 6 months, dose 2
Symptoms: Diagnosed with Sarcoidosis which actually started before vaccine so nothing to do with it
Healthcare visit (other): Specialists
Release 11 — 12 months, dose 2
Symptoms: Another uveitis flare up due to Sarcoidosis-no relation to vaccine , booster or Covid
Release 12 — 12 months, dose 3
Symptoms: Covid mild case in August On paxlovid
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 | Office visit | ✓ | · | ✓ |
| SD | Condition aggravated | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Injection site swelling | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release