4QP-71176-21757
4 vaccinations
8 coded responses
40 check-ins
8 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 629 / IL
- Registered
- 2021-01-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-15
Registered in v-safe
-
2021-01-15
Dose 1 — Moderna
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
-
2021-01-19
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: GoodFree text: Slight stress headache caused by difficulty in scheduling 2nd shot. Could not get the 2nd shot in 28 days, but had to settle for 6 days beyond the 28 days. This is in Southern Illinois.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-21
- 2021-01-22
- 2021-01-29
- 2021-02-05
- 2021-02-12
-
2021-02-16
Dose 2 — Moderna
-
2021-02-19
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body achesAdult check-in
-
2021-02-20
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Fatigue or tiredness, DiarrheaAdult check-in
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-05-18
- 2021-08-17
-
2021-09-17
Dose 3 — Moderna
- 2021-10-26
-
2021-10-29
Survey response — day 42, dose 3MedDRA: Nasal congestion, Paranasal sinus hypersecretion — Feeling: GoodFree text: Sinus drainage and stuffy nose. No fever.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-17
Survey response — 3 months, dose 3MedDRA: Headache, Self-medication, Sinusitis — Feeling: GoodFree text: Sinusitis. No fever. Taking decongestants. Specifically Coricidin HBP. Tylenol for headache. Not COVID-19 related.MedDRA releases: 2024-11 · check-in free text available
-
2022-03-18
Survey response — 6 months, dose 3MedDRA: Hypersensitivity, Lacrimation increased, Pre-existing disease, Sneezing — Feeling: Fair · Be unable to do your normal daily activitiesFree text: More severe allergies to pollen. Sneezing. Watery eyes. This did not completely prevent me from doing daily things, but curtailed my time outside.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-12
Dose 4 — Moderna
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2022-04-14
Survey response — days 1–6 daily, dose 4MedDRA: Adverse reaction, Loss of personal independence in daily activities — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains · Be unable to do your normal daily activitiesFree text: I am two days out from the injection. They were moderate to severe fir several hours, but much better today; and no fever. Resumed regular activity.MedDRA releases: 2024-11 · check-in free text available
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2022-04-15
Survey response — days 1–6 daily, dose 4MedDRA: Pain in extremity — Feeling: GoodFree text: Still have a sore arm.MedDRA releases: 2024-11 · check-in free text available
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2022-04-16
Survey response — days 1–6 daily, dose 4MedDRA: Injection site pain, Injection site swelling — Feeling: GoodFree text: Pain and swelling at injection site gone.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-17
- 2022-04-18
- 2022-04-19
- 2022-04-26
- 2022-05-03
-
2022-05-15
Survey response — day 28, dose 4MedDRA: Pre-existing disease — Feeling: FairFree text: Allergies, not Covid relatedMedDRA releases: 2024-11 · check-in free text available
- 2022-05-17
- 2022-05-24
- 2022-07-12
- 2022-10-11
- 2023-04-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Moderna | |
| 2 | 2021-02-16 | Moderna | |
| 3 | 2021-09-17 | Moderna | No |
| 4 | 2022-04-12 | Moderna | No |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Slight stress headache caused by difficulty in scheduling 2nd shot. Could not get the 2nd shot in 28 days, but had to settle for 6 days beyond the 28 days. This is in Southern Illinois.
Release 10 — day 42, dose 3
Symptoms: Sinus drainage and stuffy nose. No fever.
Release 10 — 3 months, dose 3
Symptoms: Sinusitis. No fever. Taking decongestants. Specifically Coricidin HBP. Tylenol for headache. Not COVID-19 related.
Release 11 — 6 months, dose 3
Symptoms: More severe allergies to pollen. Sneezing. Watery eyes. This did not completely prevent me from doing daily things, but curtailed my time outside.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): I am two days out from the injection. They were moderate to severe fir several hours, but much better today; and no fever. Resumed regular activity.
Systemic reaction (other): Still have a sore arm.
Systemic reaction (other): Pain and swelling at injection site gone.
Release 11 — day 28, dose 4
Symptoms: Allergies, not Covid related
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 | Headache | · | · | ✓ |
| SD | Hypersensitivity | · | · | ✓ |
| SD | Lacrimation increased | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Paranasal sinus hypersecretion | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SRO | Adverse reaction | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Injection site swelling | · | · | ✓ |
| SRO | Loss of personal independence in daily activities | · | · | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release