4LR-55545-07664
6 vaccinations
5 coded responses
43 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 065 / CT
- Registered
- 2021-03-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-20
Dose 1 — Moderna
-
2021-03-20
Dose 2 — Moderna
-
2021-03-22
Registered in v-safe
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2021-03-22
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to workAdult check-in
-
2021-03-23
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Joint pains, Fatigue or tirednessAdult check-in
-
2021-03-24
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Itching · Joint pains, Fatigue or tirednessAdult check-in
-
2021-03-25
Health check-in — days 1–6 daily, dose 2Feeling: Good · Joint pains, Rash, not including the immediate area around the injection siteAdult check-in
- 2021-03-26
-
2021-03-27
Health check-in — day 7, dose 2Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-05
-
2021-04-10
Survey response — day 21, dose 2MedDRA: Muscle spasms, Muscle strain, Pain in extremity — Feeling: Good · Be unable to work, Be unable to do your normal daily activitiesFree text: One severe and painful foot cramp that lated many hours and felt a strained sensation in that location for a few days. This never happened to me before and I wasn't aware of any injuryMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-17
- 2021-04-24
- 2021-05-01
- 2021-06-19
- 2021-09-18
-
2021-10-29
Dose 3 — Moderna
- 2022-03-20
-
2022-05-03
Dose 4 — Moderna
-
2022-05-03
Health check-in — day 0, dose 4Feeling: Good · Site: Pain · Joint pains, Fatigue or tirednessAdult check-in
- 2022-05-05
- 2022-05-06
- 2022-05-07
- 2022-05-08
- 2022-05-09
- 2022-05-10
-
2022-05-17
Survey response — day 14, dose 4MedDRA: Herpes simplex, Pre-existing disease, Vaccine positive rechallenge — Feeling: GoodFree text: I had an occurance of herpes simplex blisters on my nose 2 wks after second booster. Had sme thing happen within days of first covid booster it is less severe this time probably because I started Acyclovir as soon as 1st blisters appeared after 2ndMedDRA releases: 2024-11 · check-in free text available
- 2022-05-24
- 2022-05-31
- 2022-06-07
- 2022-06-15
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2022-08-05
Survey response — 3 months, dose 4MedDRA: Cough, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Extremely sore throat, fever, later an upper chest cough tested negative for covid both home and at (b)(6) siteMedDRA releases: 2024-11 · check-in free text available
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2022-09-16
Dose 5 — Moderna
- 2022-09-17
- 2022-09-18
- 2022-09-19
- 2022-09-21
- 2022-09-22
- 2022-09-24
- 2022-10-01
- 2022-10-07
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2022-10-15
Survey response — day 28, dose 5MedDRA: Dysphonia, Nasopharyngitis, Oral herpes — Feeling: GoodFree text: Cold, non covid, w cold sores(trated w acyclovir) and resulting hoarsenessMedDRA releases: 2024-11 · check-in free text available
- 2022-10-21
- 2022-10-29
- 2022-12-18
- 2023-03-18
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2023-04-28
Dose 6 — Pfizer-BioNTech
- 2023-05-19
- 2023-06-02
- 2023-06-09
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-20 | Moderna | |
| 2 | 2021-03-20 | Moderna | |
| 3 | 2021-10-29 | Moderna | No |
| 4 | 2022-05-03 | Moderna | No |
| 5 | 2022-09-16 | Moderna | No |
| 6 | 2023-04-28 | Pfizer-BioNTech | No |
Free text
Release 7 — day 21, dose 2
Symptoms: One severe and painful foot cramp that lated many hours and felt a strained sensation in that location for a few days. This never happened to me before and I wasn't aware of any injury
Release 11 — day 14, dose 4
Symptoms: I had an occurance of herpes simplex blisters on my nose 2 wks after second booster. Had sme thing happen within days of first covid booster it is less severe this time probably because I started Acyclovir as soon as 1st blisters appeared after 2nd cut off by CDC
Release 12 — 3 months, dose 4
Symptoms: Extremely sore throat, fever, later an upper chest cough tested negative for covid both home and at (b)(6) site
redacted (b)(6)
Release 12 — day 28, dose 5
Symptoms: Cold, non covid, w cold sores(trated w acyclovir) and resulting hoarseness
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 | Cough | · | · | ✓ |
| SD | Dysphonia | · | · | ✓ |
| SD | Herpes simplex | · | · | ✓ |
| SD | Muscle spasms | ✓ | ✓ | ✓ |
| SD | Muscle strain | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oral herpes | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Vaccine positive rechallenge | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release