4Q7-20658-53291
2 vaccinations
4 coded responses
23 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 934 / CA
- Registered
- 2021-04-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-31
Dose 1 — Moderna
-
2021-04-01
Registered in v-safe
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2021-04-02
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Joint pains, Fatigue or tirednessAdult check-in
- 2021-04-03
- 2021-04-04
- 2021-04-05
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2021-04-06
Survey response — days 1–6 daily, dose 1MedDRA: Abdominal pain, Gastrooesophageal reflux disease, Headache, Middle insomnia, Self-medication — Feeling: Fair · Abdominal painFree text: Yesterday late afternoon, I developed a headache. I took 1 Tylenol, which relieved the headache. In the middle of the night, I woke up with abdominal pain followed by severe acid reflux. I took 1 Pepcid Complete. Both symptoms subsided by late morning.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-07
Survey response — day 7, dose 1MedDRA: Burning sensation, Pre-existing disease, Rash, Rash pruritic, Self-medication — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: The rash is a little worse today. It itched a little and when I scratched, it burned. I took Childrens Liquid Benadryl at night.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-14
- 2021-04-21
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2021-04-28
Dose 2 — Moderna
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2021-04-28
Survey response — day 0, dose 2MedDRA: Arthralgia, Immediate post-injection reaction, Neck pain — Feeling: Good · Site: Pain · Muscle or body achesFree text: I received my injection on my left arm and almost immediately, my neck and shoulder on my left side started to ache.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-29
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-04-30
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-05-01
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tiredness, Abdominal painAdult check-in
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2021-05-02
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-05-04
- 2021-05-05
- 2021-05-12
- 2021-05-19
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2021-05-26
Survey response — day 28, dose 2MedDRA: Gastrointestinal disorder — Feeling: FairFree text: Digestive issuesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-02
- 2021-06-09
- 2021-07-28
- 2021-10-27
- 2022-04-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-31 | Moderna | |
| 2 | 2021-04-28 | Moderna |
Free text
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): Yesterday late afternoon, I developed a headache. I took 1 Tylenol, which relieved the headache. In the middle of the night, I woke up with abdominal pain followed by severe acid reflux. I took 1 Pepcid Complete. Both symptoms subsided by late morning.
Release 7 — day 7, dose 1
Systemic reaction (other): The rash is a little worse today. It itched a little and when I scratched, it burned. I took Childrens Liquid Benadryl at night.
Release 8 — day 0, dose 2
Systemic reaction (other): I received my injection on my left arm and almost immediately, my neck and shoulder on my left side started to ache.
Release 8 — day 28, dose 2
Symptoms: Digestive issues
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 | Gastrointestinal disorder | ✓ | ✓ | ✓ |
| SRO | Abdominal pain | ✓ | ✓ | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Burning sensation | ✓ | ✓ | ✓ |
| SRO | Gastrooesophageal reflux disease | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Immediate post-injection reaction | ✓ | ✓ | ✓ |
| SRO | Middle insomnia | ✓ | ✓ | ✓ |
| SRO | Neck pain | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Rash pruritic | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release