4DF-40502-57720
4 vaccinations
4 coded responses
29 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 496 / MI
- Registered
- 2021-01-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-06
Registered in v-safe
-
2021-01-06
Dose 1 — Moderna
- 2021-01-06
- 2021-01-07
- 2021-01-09
- 2021-01-12
-
2021-01-13
Survey response — day 7, dose 1MedDRA: Bronchial secretion retention, Pre-existing disease, Respiratory tract congestion, Wheezing — Feeling: GoodFree text: I've had ongoing wheezing, chest congestion, and bronchial mucus, but I'm quite certain this due to my asthma and it's nothing new. More of a near-daily annoyance, but thought I should add it to the record.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-21
- 2021-01-29
-
2021-02-03
Dose 2 — Moderna
-
2021-02-04
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-02-05
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches · Be unable to workFree text: Lightheaded. Similar feeling yesterday but I may not have reported it.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-06
- 2021-02-07
-
2021-02-08
Survey response — days 1–6 daily, dose 2MedDRA: Migraine, Vomiting — Feeling: Poor · Chills, Headache, Nausea · Be unable to work, Be unable to do your normal daily activitiesFree text: I woke up with a migraine. Vomiting helped alleviate it. I dont think it was caused by the vaccine, but reporting anyway.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-11
- 2021-02-17
- 2021-08-06
-
2021-10-09
Dose 3 — Moderna
- 2021-10-25
- 2021-10-31
- 2021-11-06
- 2021-11-13
- 2021-11-21
- 2022-04-11
-
2022-05-20
Dose 4 — Pfizer-BioNTech
- 2022-05-21
- 2022-05-23
- 2022-05-29
- 2022-06-03
-
2022-06-10
Survey response — day 21, dose 4MedDRA: Fatigue, Headache — Feeling: FairFree text: Headache, fatigueMedDRA releases: 2024-11 · check-in free text available
- 2022-06-17
- 2022-06-24
- 2023-05-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-06 | Moderna | |
| 2 | 2021-02-03 | Moderna | |
| 3 | 2021-10-09 | Moderna | No |
| 4 | 2022-05-20 | Pfizer-BioNTech | No |
Free text
Release 1 — day 7, dose 1
Systemic reaction (other): I've had ongoing wheezing, chest congestion, and bronchial mucus, but I'm quite certain this due to my asthma and it's nothing new. More of a near-daily annoyance, but thought I should add it to the record.
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Lightheaded. Similar feeling yesterday but I may not have reported it.
Systemic reaction (other): I woke up with a migraine. Vomiting helped alleviate it. I dont think it was caused by the vaccine, but reporting anyway.
Release 12 — day 21, dose 4
Symptoms: Headache, fatigue
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 | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SRO | Bronchial secretion retention | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Migraine | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SRO | Vomiting | ✓ | ✓ | ✓ |
| SRO | Wheezing | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release