4LT-17963-99619
5 vaccinations
7 coded responses
65 check-ins
7 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 100 / NY
- Registered
- 2021-01-09
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-08
Dose 1 — Moderna
-
2021-01-09
Registered in v-safe
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2021-01-09
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Itching · Headache, Fatigue or tirednessAdult check-in
- 2021-01-10
- 2021-01-11
- 2021-01-12
- 2021-01-13
- 2021-01-14
- 2021-01-15
-
2021-01-22
Survey response — day 14, dose 1MedDRA: Injection site erythema — Feeling: GoodFree text: Redness on upper arm where injection was givenMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-29
Survey response — day 21, dose 1MedDRA: Unevaluable event — Feeling: Fair · Be unable to do your normal daily activitiesFree text: However, these are symptoms I typically get with sinus issues.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-05
Dose 2 — Moderna
- 2021-02-05
-
2021-02-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-07
Survey response — days 1–6 daily, dose 2MedDRA: Hypogeusia, Hyposmia — Feeling: Good · Site: PainFree text: weakened sense of smell and tasteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-12
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2021-02-19
Survey response — day 14, dose 2MedDRA: Arthritis, Cough, Injection site erythema, Neck pain, Pain in jaw, Pre-existing disease, Sinus disorder — Feeling: GoodFree text: Before the last check-in I was having lower jaw/neck pain which I thought was relate to a cough/sinus condition, although I never had such pain with sinus conditions. Arthritis pain in my thumbs also was much worse. Today the shot area is red.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-26
- 2021-03-05
- 2021-03-12
- 2021-03-19
- 2021-05-07
- 2021-08-08
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2021-10-29
Dose 3 — Moderna
- 2021-10-29
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2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-10-31
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Redness, Swelling, Itching · NoneAdult check-in
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-05
- 2021-11-12
- 2021-11-19
- 2021-11-26
- 2021-12-03
- 2021-12-12
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2022-01-29
Survey response — 3 months, dose 3MedDRA: Fatigue, Headache, Laboratory test abnormal — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Very painful headaches and very tired which began on 1/13/2022. My home test was negative that morning. The second one was positive 1/16/2022. A rapid test and PCR at a testing van that same day were both positive.MedDRA releases: 2024-11 · check-in free text available
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2022-04-08
Dose 4 — Moderna
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2022-04-09
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Itching · Headache, Fatigue or tirednessAdult check-in
-
2022-04-10
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Redness, Swelling, Itching · NoneAdult check-in
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2022-04-11
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Redness, Swelling, Itching · NoneAdult check-in
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2022-04-12
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Redness, Itching · NoneAdult check-in
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2022-04-13
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Redness, Itching · NoneAdult check-in
-
2022-04-14
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Redness, Itching · NoneAdult check-in
- 2022-04-15
- 2022-04-22
- 2022-04-29
- 2022-05-06
- 2022-05-13
- 2022-05-20
- 2022-07-08
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2022-09-17
Dose 5 — ModernaCo-administered: Flu
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2022-09-18
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain, Swelling, Itching · HeadacheAdult check-in
- 2022-09-19
- 2022-09-20
- 2022-09-21
- 2022-09-22
- 2022-09-23
- 2022-09-24
- 2022-10-01
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2022-10-08
Survey response — day 21, dose 5MedDRA: Fatigue, Headache, Oropharyngeal pain, Respiratory tract congestion, Sinus congestion — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Headache, sore throat, tiredness, some sinus and chest congestionMedDRA releases: 2024-11 · check-in free text available
-
2022-10-15
Survey response — day 28, dose 5MedDRA: Cough, Headache, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Congestion, headache, coughMedDRA releases: 2024-11 · check-in free text available
- 2022-10-22
- 2022-10-29
- 2022-12-17
- 2023-03-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-08 | Moderna | |
| 2 | 2021-02-05 | Moderna | |
| 3 | 2021-10-29 | Moderna | No |
| 4 | 2022-04-08 | Moderna | No |
| 5 | 2022-09-17 | Moderna | Flu |
Free text
Release 2 — day 14, dose 1
Symptoms: Redness on upper arm where injection was given
Release 3 — day 21, dose 1
Symptoms: However, these are symptoms I typically get with sinus issues.
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): weakened sense of smell and taste
Release 4 — day 14, dose 2
Symptoms: Before the last check-in I was having lower jaw/neck pain which I thought was relate to a cough/sinus condition, although I never had such pain with sinus conditions. Arthritis pain in my thumbs also was much worse. Today the shot area is red.
Release 11 — 3 months, dose 3
Symptoms: Very painful headaches and very tired which began on 1/13/2022. My home test was negative that morning. The second one was positive 1/16/2022. A rapid test and PCR at a testing van that same day were both positive.
Release 12 — day 21, dose 5
Symptoms: Headache, sore throat, tiredness, some sinus and chest congestion
Release 12 — day 28, dose 5
Symptoms: Congestion, headache, cough
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 | Arthritis | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Injection site erythema | ✓ | ✓ | ✓ |
| SD | Laboratory test abnormal | · | · | ✓ |
| SD | Neck pain | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain in jaw | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SD | Sinus disorder | ✓ | ✓ | ✓ |
| SD | Unevaluable event | ✓ | ✓ | ✓ |
| SRO | Hypogeusia | ✓ | ✓ | ✓ |
| SRO | Hyposmia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release