4MM-10634-32777
2 vaccinations
4 coded responses
18 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 125 / NY
- Registered
- 2020-12-24
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-24
Registered in v-safe
-
2020-12-24
Dose 1 — Moderna
-
2020-12-24
Health check-in — day 0, dose 1Feeling: Fair · Site: Pain · Fever · Rash, not including the immediate area around the injection siteAdult check-in
- 2020-12-25
- 2020-12-27
- 2020-12-28
- 2020-12-29
- 2021-01-01
-
2021-01-08
Survey response — day 14, dose 1MedDRA: Erythema, Skin warm, Swelling — Feeling: GoodFree text: I noticed a raised, red and hot to touch with NO itching or pain on 1/1 which was a week after the vaccination (but please note from the initial injection to about a day and a half after I only had a mild red area).MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-17
-
2021-01-21
Dose 2 — Moderna
-
2021-01-23
Survey response — days 1–6 daily, dose 2MedDRA: Diarrhoea, Headache, Pyrexia, Self-medication — Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tirednessFree text: These are from today. The symptoms from the day (1/22)after were more severe inlduing headache mild fever and diarrhea but were resolved with Tylenol and OTC anti diarrhea pillsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-25
- 2021-01-28
- 2021-02-06
- 2021-02-19
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2021-02-26
Survey response — day 35, dose 2MedDRA: Nasopharyngitis — Feeling: FairFree text: Cold type symptomsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-06
- 2021-04-22
- 2021-07-22
-
2022-01-24
Survey response — 12 months, dose 2MedDRA: Emergency care, Loss of consciousness — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Passed out · Healthcare visit (other): EmsMedDRA releases: 2024-11 · check-in free text available
-
2022-01-24
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
-
2022-01-27
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-24 | Moderna | |
| 2 | 2021-01-21 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 1 — day 14, dose 1
Symptoms: I noticed a raised, red and hot to touch with NO itching or pain on 1/1 which was a week after the vaccination (but please note from the initial injection to about a day and a half after I only had a mild red area).
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): These are from today. The symptoms from the day (1/22)after were more severe inlduing headache mild fever and diarrhea but were resolved with Tylenol and OTC anti diarrhea pills
Release 4 — day 35, dose 2
Symptoms: Cold type symptoms
Release 11 — 12 months, dose 2
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 | Emergency care | · | · | ✓ |
| SD | Erythema | ✓ | ✓ | ✓ |
| SD | Loss of consciousness | · | · | ✓ |
| SD | Nasopharyngitis | ✓ | ✓ | ✓ |
| SD | Skin warm | ✓ | ✓ | ✓ |
| SD | Swelling | ✓ | ✓ | ✓ |
| SRO | Diarrhoea | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release