4PH-17424-32984
6 vaccinations
3 coded responses
74 check-ins
3 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 857 / AZ
- Registered
- 2021-03-17
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-15
Dose 1 — Moderna
-
2021-03-17
Registered in v-safe
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-04-06
-
2021-04-15
Dose 2 — Moderna
- 2021-04-15
- 2021-04-16
- 2021-04-17
- 2021-04-18
- 2021-04-19
- 2021-04-20
- 2021-04-21
- 2021-04-22
- 2021-04-29
- 2021-05-06
- 2021-05-13
- 2021-05-20
- 2021-05-27
-
2021-07-15
Survey response — 3 months, dose 2MedDRA: Eyelid margin crusting, Headache, Oropharyngeal pain — Feeling: GoodFree text: Severe sore throat that lasted two weeks; headaches for three days at the onset of the sore throat; and a significant amount of matter present in the eye for a few days just before the sore throat presented. This occurred 4 wks after being fully vacdMedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-10-14
-
2021-11-01
Dose 3 — Moderna
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-05
- 2021-11-06
- 2021-11-07
- 2021-11-08
- 2021-11-15
- 2021-11-23
- 2021-11-29
- 2021-12-06
-
2021-12-13
Survey response — day 42, dose 3MedDRA: Eye discharge, Migraine, Oropharyngeal pain, Reaction to previous exposure to any vaccine — Feeling: FairFree text: Severe migraine headaches for last 3 consecutive days, similar to same symptoms that occurred 4 weeks after my 2nd Moderna shot. Waiting to see if I also experience a severe sore throat and excretion of large amts of grey matter from my tear ducts.MedDRA releases: 2024-11 · check-in free text available
- 2022-01-31
-
2022-04-29
Dose 4 — Moderna
- 2022-04-30
- 2022-05-01
- 2022-05-02
- 2022-05-03
- 2022-05-04
- 2022-05-05
- 2022-05-06
- 2022-05-13
- 2022-05-20
- 2022-05-27
- 2022-06-03
- 2022-06-10
- 2022-07-31
-
2022-10-05
Dose 5 — Moderna
-
2022-10-06
Survey response — days 1–6 daily, dose 5MedDRA: Injection site pain — Feeling: Good · Site: RednessFree text: Just soreness around injection siteMedDRA releases: 2024-11 · check-in free text available
- 2022-10-07
- 2022-10-08
- 2022-10-09
- 2022-10-10
- 2022-10-11
- 2022-10-12
- 2022-10-19
- 2022-10-26
- 2022-11-02
- 2022-11-09
- 2022-11-16
- 2023-01-04
- 2023-04-05
-
2023-05-01
Dose 6 — Moderna
- 2023-05-03
- 2023-05-04
- 2023-05-05
- 2023-05-06
- 2023-05-07
- 2023-05-08
- 2023-05-15
- 2023-05-22
- 2023-05-29
- 2023-06-05
- 2023-06-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-15 | Moderna | |
| 2 | 2021-04-15 | Moderna | |
| 3 | 2021-11-01 | Moderna | No |
| 4 | 2022-04-29 | Moderna | No |
| 5 | 2022-10-05 | Moderna | No |
| 6 | 2023-05-01 | Moderna | No |
Free text
Release 9 — 3 months, dose 2
Symptoms: Severe sore throat that lasted two weeks; headaches for three days at the onset of the sore throat; and a significant amount of matter present in the eye for a few days just before the sore throat presented. This occurred 4 wks after being fully vacd cut off by CDC
Release 10 — day 42, dose 3
Symptoms: Severe migraine headaches for last 3 consecutive days, similar to same symptoms that occurred 4 weeks after my 2nd Moderna shot. Waiting to see if I also experience a severe sore throat and excretion of large amts of grey matter from my tear ducts. cut off by CDC
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Just soreness around injection site
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 | Eye discharge | · | · | ✓ |
| SD | Eyelid margin crusting | ✓ | · | ✓ |
| SD | Headache | ✓ | · | ✓ |
| SD | Migraine | · | · | ✓ |
| SD | Oropharyngeal pain | ✓ | · | ✓ |
| SD | Reaction to previous exposure to any vaccine | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release