4GN-30899-56233
3 vaccinations
6 coded responses
31 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 927 / CA
- Registered
- 2021-01-15
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Registered dependents
456-42577-77056
Child or adolescent in my care · Male · 2021-11-09
B5S-13943-41805
Child or adolescent in my care · Male · 2021-11-09
Timeline
-
2021-01-15
Registered in v-safe
-
2021-01-15
Dose 1 — Moderna
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-19
- 2021-01-21
- 2021-01-22
- 2021-01-29
- 2021-02-05
-
2021-02-12
Dose 2 — Moderna
- 2021-02-12
-
2021-02-13
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-08-13
-
2021-10-22
Dose 3 — Moderna
-
2021-10-24
Survey response — days 1–6 daily, dose 3MedDRA: Nasal congestion — Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Nasal congestion.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-25
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Redness, Swelling, Itching · NoneAdult check-in
-
2021-10-26
Survey response — days 1–6 daily, dose 3MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good · Site: Redness, Swelling, ItchingFree text: Enlarged tender axillary lymph nodes since receiving the vaccine, but this is improving daily.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good · Site: ItchingFree text: Still have mildly enlarged and tender left axillary lymph nodes, but this is improving slowly.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-28
Survey response — days 1–6 daily, dose 3MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good · Site: Pain, ItchingFree text: Still slightly enlarged and tender axillary lymphadenopathy.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-29
Survey response — day 7, dose 3MedDRA: Lymphadenopathy — Feeling: Good · Site: ItchingFree text: Axillary lymphadenopathy has resolved.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-05
- 2021-11-12
- 2021-11-19
- 2021-11-26
- 2021-12-03
- 2022-01-21
-
2022-04-22
Survey response — 6 months, dose 3MedDRA: Chills, Fatigue, Influenza, Nasal congestion, Nasopharyngitis, Oropharyngeal pain, Pain, Rhinorrhoea — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Either a flu or cold, with symptoms of sore throat, body aches, chills, fatigue, stuffy/runny nose.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Moderna | |
| 2 | 2021-02-12 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Nasal congestion.
Systemic reaction (other): Enlarged tender axillary lymph nodes since receiving the vaccine, but this is improving daily.
Systemic reaction (other): Still have mildly enlarged and tender left axillary lymph nodes, but this is improving slowly.
Systemic reaction (other): Still slightly enlarged and tender axillary lymphadenopathy.
Release 10 — day 7, dose 3
Systemic reaction (other): Axillary lymphadenopathy has resolved.
Release 11 — 6 months, dose 3
Symptoms: Either a flu or cold, with symptoms of sore throat, body aches, chills, fatigue, stuffy/runny nose.
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 | Chills | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Lymph node pain | · | · | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Nasal congestion | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release