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4JL-12493-79283

3 vaccinations 11 coded responses 35 check-ins 11 free-text entries 0 call cases
Sex
Female
Age at first dose
51-55
ZIP prefix
161 / PA
Registered
2021-04-16
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-04-15
    Dose 1 — Moderna
  2. 2021-04-16
    Registered in v-safe
  3. 2021-04-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain, Redness · Headache, Fatigue or tiredness
    Adult check-in
  4. 2021-04-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Redness · None
    Adult check-in
  5. 2021-04-18
    Survey response — days 1–6 daily, dose 1
    MedDRA: Paranasal sinus hypersecretion, Throat irritation — Feeling: Fair · Fever · Headache, Fatigue or tiredness
    Free text: Sinus drainage and throat irritation
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-04-19
    Survey response — days 1–6 daily, dose 1
    MedDRA: Paranasal sinus hypersecretion, Throat irritation — Feeling: Good · Fever · Headache
    Free text: Minor sinus drainage and throat irritation.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-04-20
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Fever · Fatigue or tiredness
    Adult check-in
  8. 2021-04-21
    Survey response — days 1–6 daily, dose 1
    MedDRA: Paranasal sinus hypersecretion, Throat irritation — Feeling: Fair · Fever · Headache, Fatigue or tiredness
    Free text: Mild sinus drainage and throat irritation
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-04-22
    Survey response — day 7, dose 1
    MedDRA: Paranasal sinus hypersecretion — Feeling: Fair · Fatigue or tiredness
    Free text: A little sinus drainage
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-04-29
    Health check-in — day 14, dose 1
    Feeling: Fair
    Adult check-in
  11. 2021-05-06
    Survey response — day 21, dose 1
    MedDRA: Cough, Dyspnoea, Headache — Feeling: Good
    Free text: I've developed a light cough with sort of raw breathless feeling down my trachea. Not sure if it's related to the shot, allergies, or something else. I've also periodically had a worse headache, which also could be related to allergie something else.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-05-13
    Dose 2 — Moderna
  13. 2021-05-13
    Survey response — day 0, dose 2
    MedDRA: Pruritus — Feeling: Good · Rash, not including the immediate area around the injection site
    Free text: Itching not at the injection site
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-05-14
    Survey response — days 1–6 daily, dose 2
    MedDRA: Herpes zoster — Feeling: Good · Site: Pain, Redness, Itching · Fever · Headache, Rash, not including the immediate area around the injection site
    Free text: Three and a half weeks after my first shot and four days before my second shot, I developed a small patch of shingles on my right shoulder, which is the arm I received my first shot in.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-05-15
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Redness, Itching · Headache
    Adult check-in
  16. 2021-05-16
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Itching · None
    Adult check-in
  17. 2021-05-17
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  18. 2021-05-19
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-05-20
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-05-27
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-06-03
    Survey response — day 21, dose 2
    MedDRA: Headache — Feeling: Good
    Free text: Persistent headache, daily, for the past week.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-06-10
    Survey response — day 28, dose 2
    MedDRA: Abdominal discomfort, Arthralgia, Fatigue, Pyrexia, Sensitive skin, Skin burning sensation — Feeling: Fair · Be unable to work
    Free text: For the past three days, I have experienced significant fatigue, low grade fever, and a burning and sensitivity on the left side of my scalp, left shoulder, and left waist areas (maybe another shingles outbreak?).
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  23. 2021-06-17
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-06-24
    Survey response — day 42, dose 2
    MedDRA: Headache — Feeling: Fair
    Free text: I have had a worsening headache every day for about three weeks
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  25. 2021-08-12
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-11-11
    Survey response — 6 months, dose 2
    MedDRA: Arthritis, Headache, Spinal stenosis — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Persistent headache for more than a month. I've also had steroid injections for knee arthritis and spinal stenosis.
    MedDRA releases: 2024-11 · check-in free text available
  27. 2022-03-28
    Dose 3 — Moderna
  28. 2022-03-29
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  29. 2022-03-30
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain, Redness · None
    Adult check-in
  30. 2022-04-01
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  31. 2022-04-02
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  32. 2022-04-03
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  33. 2022-04-04
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  34. 2022-04-11
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  35. 2022-04-18
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  36. 2022-04-25
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  37. 2022-05-02
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  38. 2022-05-09
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  39. 2022-06-27
    Health check-in — 3 months, dose 3
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-04-15Moderna
22021-05-13Moderna
32022-03-28Moderna No

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-18

Systemic reaction (other): Sinus drainage and throat irritation

2021-04-19

Systemic reaction (other): Minor sinus drainage and throat irritation.

2021-04-21

Systemic reaction (other): Mild sinus drainage and throat irritation

Release 7 — day 7, dose 1

2021-04-22

Systemic reaction (other): A little sinus drainage

Release 8 — day 21, dose 1

2021-05-06

Symptoms: I've developed a light cough with sort of raw breathless feeling down my trachea. Not sure if it's related to the shot, allergies, or something else. I've also periodically had a worse headache, which also could be related to allergie something else. cut off by CDC

Release 8 — day 0, dose 2

2021-05-13

Systemic reaction (other): Itching not at the injection site

Release 8 — days 1–6 daily, dose 2

2021-05-14

Systemic reaction (other): Three and a half weeks after my first shot and four days before my second shot, I developed a small patch of shingles on my right shoulder, which is the arm I received my first shot in.

Release 8 — day 21, dose 2

2021-06-03

Symptoms: Persistent headache, daily, for the past week.

Release 9 — day 28, dose 2

2021-06-10

Symptoms: For the past three days, I have experienced significant fatigue, low grade fever, and a burning and sensitivity on the left side of my scalp, left shoulder, and left waist areas (maybe another shingles outbreak?).

Release 9 — day 42, dose 2

2021-06-24

Symptoms: I have had a worsening headache every day for about three weeks

Release 10 — 6 months, dose 2

2021-11-11

Symptoms: Persistent headache for more than a month. I've also had steroid injections for knee arthritis and spinal stenosis.

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
SDAbdominal discomfort ✓ ✓ ✓
SDArthralgia ✓ ✓ ✓
SDArthritis · · ✓
SDCough ✓ ✓ ✓
SDDyspnoea ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDPyrexia ✓ ✓ ✓
SDSensitive skin ✓ ✓ ✓
SDSkin burning sensation ✓ ✓ ✓
SDSpinal stenosis · · ✓
SROHerpes zoster ✓ ✓ ✓
SROParanasal sinus hypersecretion ✓ ✓ ✓
SROPruritus ✓ ✓ ✓
SROThroat irritation ✓ ✓ ✓

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

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