4QH-33563-90958
3 vaccinations
4 coded responses
20 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 124 / NY
- Registered
- 2021-01-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-17
Dose 1 — Moderna
-
2021-01-18
Registered in v-safe
-
2021-01-18
Survey response — days 1–6 daily, dose 1MedDRA: Chills, Fatigue — Feeling: Good · Site: Pain · Chills, Fatigue or tirednessFree text: Chill 4 hrs. after. Fatigue next day. Neither a big deal.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-19
-
2021-01-22
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: GoodFree text: Slight dizziness - worse yesterday. Continuous but quite mild.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-23
- 2021-01-24
- 2021-01-31
- 2021-02-07
- 2021-02-14
-
2021-02-16
Dose 2 — Moderna
- 2021-02-21
-
2021-02-22
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Dizziness, Fatigue, Feeling abnormal, Pain, Pyrexia — Feeling: Good · Muscle or body aches, Fatigue or tirednessFree text: For the 2 days after shot 2, had fever, chills, sches etc. and fatigue. Thereafter (from 2/ 16th have had sudden overwhelmingly fatigue but onset is later each day. Also persistent foggy sense in head onky, with dizziness if turn head too fast.shhoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-03-17
- 2021-03-23
- 2021-03-31
-
2021-05-18
Survey response — 3 months, dose 2MedDRA: Oropharyngeal pain — Feeling: GoodFree text: Probably wholly unrelated. Pain/ache on right side of throat somewhat like a swollen gland. Mildly painful; possibly muscular.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-08-17
-
2021-08-21
Dose 3 — Moderna
- 2021-11-20
- 2022-02-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-17 | Moderna | |
| 2 | 2021-02-16 | Moderna | |
| 3 | 2021-08-21 | Moderna | No |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Chill 4 hrs. after. Fatigue next day. Neither a big deal.
Systemic reaction (other): Slight dizziness - worse yesterday. Continuous but quite mild.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): For the 2 days after shot 2, had fever, chills, sches etc. and fatigue. Thereafter (from 2/ 16th have had sudden overwhelmingly fatigue but onset is later each day. Also persistent foggy sense in head onky, with dizziness if turn head too fast.shho
Release 8 — 3 months, dose 2
Symptoms: Probably wholly unrelated. Pain/ache on right side of throat somewhat like a swollen gland. Mildly painful; possibly muscular.
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 | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release