4MB-30842-16958
3 vaccinations
5 coded responses
41 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 782 / TX
- Registered
- 2021-04-03
- Relationship
- Self
- Race
- N/A
- Ethnicity
- Hispanic or Latino
Registered dependents
Z9F-23026-91989
Child or adolescent in my care · Female · 2022-01-23
Timeline
-
2021-04-03
Registered in v-safe
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2021-04-03
Dose 1 — Moderna
- 2021-04-03
-
2021-04-04
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: GoodFree text: Soreness at injection site at night for a few hoursMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-09
- 2021-04-10
- 2021-04-17
- 2021-04-24
-
2021-05-01
Dose 2 — Moderna
- 2021-05-01
-
2021-05-02
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pain, Pain in extremity — Feeling: Poor · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: Pain at site soreness through whole arm to my fingersMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-03
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: Mild pain at siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-04
- 2021-05-05
- 2021-05-06
- 2021-05-07
- 2021-05-08
- 2021-05-15
- 2021-05-22
- 2021-05-29
- 2021-06-05
- 2021-06-12
- 2021-07-31
- 2021-10-30
-
2021-11-11
Dose 3 — ModernaCo-administered: Flu
- 2021-11-11
-
2021-11-12
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Swelling, Itching · ChillsAdult check-in
-
2021-11-13
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Redness, Swelling · Fever · ChillsAdult check-in
-
2021-11-14
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Redness, Swelling · NoneAdult check-in
- 2021-11-15
- 2021-11-16
-
2021-11-17
Survey response — days 1–6 daily, dose 3MedDRA: Back pain, Chest pain — Feeling: Fair · Site: Itching · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I have had a small pain chest right side, under the breast and ribs. Very strong last night. And goes to back same place as front but backside. Sharp sudden pain. Don't know if it's a symptomMedDRA releases: 2024-11 · check-in free text available
-
2021-11-17
Report sent to call center — days 1–6 daily, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-11-18
- 2021-11-18
- 2021-11-25
- 2021-12-02
- 2021-12-09
- 2021-12-16
- 2021-12-23
- 2022-02-10
- 2022-05-12
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2022-11-11
Survey response — 12 months, dose 3MedDRA: COVID-19, Dyspnoea, Fatigue, Heart rate increased, Office visit, Productive cough — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Got covid in July. Symptoms after that have not gone away Cough with phlegm, Shortness of breath fatigue fast heartbeat until I sit down or lie down my heart rate comes back to normal and no shortness of breath · Healthcare visit (other): Seeing my Pcp doctorMedDRA releases: 2024-11 · check-in free text available
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2022-11-11
Report sent to call center — 12 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-11-14
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-11-14
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-03 | Moderna | |
| 2 | 2021-05-01 | Moderna | |
| 3 | 2021-11-11 | Moderna | Flu |
Call center
2 call center cases
2 successful
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Soreness at injection site at night for a few hours
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Pain at site soreness through whole arm to my fingers
Systemic reaction (other): Mild pain at site
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): I have had a small pain chest right side, under the breast and ribs. Very strong last night. And goes to back same place as front but backside. Sharp sudden pain. Don't know if it's a symptom
Release 12 — 12 months, dose 3
Symptoms: Got covid in July. Symptoms after that have not gone away Cough with phlegm, Shortness of breath fatigue fast heartbeat until I sit down or lie down my heart rate comes back to normal and no shortness of breath
Healthcare visit (other): Seeing my Pcp doctor
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 |
|---|---|---|---|---|
| HCVO | Office visit | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Heart rate increased | · | · | ✓ |
| SD | Productive cough | · | · | ✓ |
| SRO | Back pain | · | · | ✓ |
| SRO | Chest pain | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release