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4JV-18102-12237

3 vaccinations 7 coded responses 14 check-ins 7 free-text entries 1 call case
Sex
Female
Age at first dose
56-60
ZIP prefix
808 / CO
Registered
2021-05-15
Relationship
Self
Race
Other
Ethnicity
Hispanic or Latino

Timeline

  1. 2021-04-13
    Dose 1 — Moderna
  2. 2021-05-12
    Dose 2 — Moderna
  3. 2021-05-15
    Registered in v-safe
  4. 2021-05-15
    Survey response — days 1–6 daily, dose 2
    MedDRA: Dehydration — Feeling: Fair
    Free text: Very dehydrated, not normal for me
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-05-16
    Survey response — days 1–6 daily, dose 2
    MedDRA: Dehydration — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness
    Free text: Still feeling dehydrated, not as much as yesterday. No normal reason for dehydration.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-05-18
    Survey response — days 1–6 daily, dose 2
    MedDRA: Chills, Lip dry, Oral discomfort, Oral herpes — Feeling: Good
    Free text: Yesterday was better, noticed lips still very dry and have had a burning sensation and developed cold soars I never knew I had. Checked temperature last 2 days between 98.3-98.4. Never felt chills or fever. Feel okay today.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-05-19
    Survey response — day 7, dose 2
    MedDRA: Unevaluable event — Feeling: Good
    Free text: My lips are still recovering (sounds strange), no other symptoms.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-05-26
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  9. 2021-06-02
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  10. 2021-06-09
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  11. 2021-06-18
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-06-23
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-08-11
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-11-10
    Survey response — 6 months, dose 2
    MedDRA: Chest pain, Oropharyngeal pain, Pharyngeal swelling, Pyrexia — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Burning in the chest, sore throat, fever, swollen feeling in the throat
    MedDRA releases: 2024-11 · check-in free text available
  15. 2021-11-26
    Dose 3 — Moderna
  16. 2022-05-12
    Survey response — 12 months, dose 2
    MedDRA: Office visit, Oropharyngeal pain, Swelling — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Symptoms: It is not "new." I honestly don't think it has anything to do with COVID For the last 2 years I have had a, at first occasional, now constant sore throat with a swollen feeling in my throat. I'm seeing specialist, but they are still unsure cause · Healthcare visit (other): Primary care Physician and specialist
    MedDRA releases: 2024-11 · check-in free text available
  17. 2022-05-12
    Report sent to call center — 12 months, dose 2
    Be unable to work or attend school · Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · 1 call case(s)
  18. 2022-05-13
  19. 2022-05-13
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  20. 2022-05-27
    Survey response — 6 months, dose 3
    MedDRA: No adverse event — Feeling: Fair
    Free text: I HAVE NOT experienced any symptoms, but both my husband and son are sick. They both tested negative to a 15 minute self test. If they do not feel better by tomorrow I am asking them to go to our local COVID testing site so it can be sent in.
    MedDRA releases: 2024-11 · check-in free text available
  21. 2022-11-26
    Health check-in — 12 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-04-13Moderna
22021-05-12Moderna
32021-11-26Moderna No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 8 — days 1–6 daily, dose 2

2021-05-15

Systemic reaction (other): Very dehydrated, not normal for me

2021-05-16

Systemic reaction (other): Still feeling dehydrated, not as much as yesterday. No normal reason for dehydration.

2021-05-18

Systemic reaction (other): Yesterday was better, noticed lips still very dry and have had a burning sensation and developed cold soars I never knew I had. Checked temperature last 2 days between 98.3-98.4. Never felt chills or fever. Feel okay today.

Release 8 — day 7, dose 2

2021-05-19

Systemic reaction (other): My lips are still recovering (sounds strange), no other symptoms.

Release 10 — 6 months, dose 2

2021-11-10

Symptoms: Burning in the chest, sore throat, fever, swollen feeling in the throat

Release 11 — 12 months, dose 2

2022-05-12

Symptoms: It is not "new." I honestly don't think it has anything to do with COVID For the last 2 years I have had a, at first occasional, now constant sore throat with a swollen feeling in my throat. I'm seeing specialist, but they are still unsure cause
Healthcare visit (other): Primary care Physician and specialist

Release 11 — 6 months, dose 3

2022-05-27

Symptoms: I HAVE NOT experienced any symptoms, but both my husband and son are sick. They both tested negative to a 15 minute self test. If they do not feel better by tomorrow I am asking them to go to our local COVID testing site so it can be sent in.

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
HCVOOffice visit · · ✓
SDChest pain · · ✓
SDNo adverse event · · ✓
SDOffice visit · · ✓
SDOropharyngeal pain · · ✓
SDPharyngeal swelling · · ✓
SDPyrexia · · ✓
SDSwelling · · ✓
SROChills ✓ ✓ ✓
SRODehydration ✓ ✓ ✓
SROLip dry ✓ ✓ ✓
SROOral discomfort ✓ ✓ ✓
SROOral herpes ✓ ✓ ✓
SROUnevaluable event ✓ ✓ ✓

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