4S6-19289-52096
2 vaccinations
6 coded responses
21 check-ins
6 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 442 / OH
- Registered
- 2021-02-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-01
Dose 1 — Moderna
-
2021-02-02
Registered in v-safe
- 2021-02-02
- 2021-02-03
- 2021-02-06
- 2021-02-07
- 2021-02-10
- 2021-02-15
- 2021-02-22
-
2021-03-01
Dose 2 — Moderna
- 2021-03-01
-
2021-03-02
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body achesFree text: TiredMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
-
2021-03-05
Survey response — days 1–6 daily, dose 2MedDRA: Abdominal pain upper, Body temperature decreased, Muscle spasms — Feeling: Good · Abdominal painFree text: One second day after I had already filled this out got sever cramps in legs arms chest and stomach. Lasted about 3 hours. Also temp fell to 91MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-07
- 2021-03-10
-
2021-03-17
Survey response — day 14, dose 2MedDRA: Office visit, Rash — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Rash on hands. No new but not going away. Noticed it the day after shot but for some reason did not think it was related · Healthcare visit (other): Saw doctorMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-17
Report sent to call center — day 14, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-22
- 2021-03-31
- 2021-04-05
- 2021-04-12
-
2021-05-31
Survey response — 3 months, dose 2MedDRA: Cough — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Cough, I feel good otherwise just take bad coughing spells.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-08-30
Survey response — 6 months, dose 2MedDRA: Cough, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Persistent cough · Healthcare visit (other): Doctors officeMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-30
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-31
-
2022-03-01
Survey response — 12 months, dose 2MedDRA: Foot fracture, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Keep fracturing bones in feet. · Healthcare visit (other): Dr officeMedDRA releases: 2024-11 · check-in free text available
-
2022-03-01
Report sent to call center — 12 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2022-03-04
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-01 | Moderna | |
| 2 | 2021-03-01 | Moderna |
Call center
3 call center cases
3 successful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Tired
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): One second day after I had already filled this out got sever cramps in legs arms chest and stomach. Lasted about 3 hours. Also temp fell to 91
Release 5 — day 14, dose 2
Symptoms: Rash on hands. No new but not going away. Noticed it the day after shot but for some reason did not think it was related
Healthcare visit (other): Saw doctor
Release 8 — 3 months, dose 2
Symptoms: Cough, I feel good otherwise just take bad coughing spells.
Release 9 — 6 months, dose 2
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 | Office visit | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Foot fracture | · | · | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SRO | Abdominal pain upper | ✓ | ✓ | ✓ |
| SRO | Body temperature decreased | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Muscle spasms | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release