4CW-88263-11703
2 vaccinations
8 coded responses
19 check-ins
8 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 604 / IL
- Registered
- 2021-03-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-18
Registered in v-safe
-
2021-03-18
Dose 1 — Moderna
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2021-03-18
Survey response — day 0, dose 1MedDRA: Chest discomfort, Feeling hot, Immediate post-injection reaction, Paraesthesia oral — Feeling: Fair · Headache · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: About 1.5 minutes of shot, I felt heat sensation go through left arm, across chest and back into Right arm, then go down into rest of body and legs. Came back up body and through head. Then about 25 minutes later tingling in lips for an hourMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-18
Report sent to call center — day 0, dose 1Get care from a doctor or other healthcare professional1 call case(s)
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2021-03-20
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: GoodFree text: Tender around shotMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-21
Survey response — days 1–6 daily, dose 1MedDRA: Depression, Hyperhidrosis — Feeling: Good · FeverFree text: Sweating in sleep and depression last 24 hoursMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-22
- 2021-03-23
- 2021-03-24
- 2021-03-25
- 2021-04-03
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2021-04-15
Dose 2 — Moderna
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2021-04-15
Survey response — day 0, dose 2MedDRA: Chills, Feeling hot — Feeling: Fair · ChillsFree text: Episodic moments of Mild chills n warmMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-16
Survey response — days 1–6 daily, dose 2MedDRA: Respiratory tract congestion, Rhinorrhoea — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaFree text: Congestion and Nasal DrainageMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-19
Survey response — days 1–6 daily, dose 2MedDRA: Feeling hot, Hyperhidrosis — Feeling: Fair · Fever · HeadacheFree text: Hot overnight sleeping, sweatingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-20
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tirednessAdult check-in
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2021-04-21
Survey response — days 1–6 daily, dose 2MedDRA: Feeling hot, Night sweats — Feeling: Fair · Fever · HeadacheFree text: Hot/sweating sleeping overnightMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-22
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2021-05-01
Survey response — day 14, dose 2MedDRA: Flatulence, Headache, Nausea, Respiratory tract congestion — Feeling: FairFree text: Queasy 2 days, congested, headache gassyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-06
- 2021-05-13
- 2021-05-22
- 2021-05-27
-
2021-12-20
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-18 | Moderna | |
| 2 | 2021-04-15 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 5 — day 0, dose 1
Systemic reaction (other): About 1.5 minutes of shot, I felt heat sensation go through left arm, across chest and back into Right arm, then go down into rest of body and legs. Came back up body and through head. Then about 25 minutes later tingling in lips for an hour
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Tender around shot
Systemic reaction (other): Sweating in sleep and depression last 24 hours
Release 7 — day 0, dose 2
Systemic reaction (other): Episodic moments of Mild chills n warm
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Congestion and Nasal Drainage
Systemic reaction (other): Hot overnight sleeping, sweating
Systemic reaction (other): Hot/sweating sleeping overnight
Release 8 — day 14, dose 2
Symptoms: Queasy 2 days, congested, headache gassy
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 | Flatulence | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SRO | Chest discomfort | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Depression | ✓ | ✓ | ✓ |
| SRO | Feeling hot | ✓ | ✓ | ✓ |
| SRO | Hyperhidrosis | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Night sweats | ✓ | ✓ | ✓ |
| SRO | Paraesthesia oral | ✓ | ✓ | ✓ |
| SRO | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SRO | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release