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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

  1. 2021-02-01
    Dose 1 — Moderna
  2. 2021-02-02
    Registered in v-safe
  3. 2021-02-02
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  4. 2021-02-03
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  5. 2021-02-06
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-02-07
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-02-10
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-02-15
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  9. 2021-02-22
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-03-01
    Dose 2 — Moderna
  11. 2021-03-01
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  12. 2021-03-02
    Survey response — days 1–6 daily, dose 2
    MedDRA: Fatigue — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches
    Free text: Tired
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-03-04
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  14. 2021-03-05
    Survey response — days 1–6 daily, dose 2
    MedDRA: Abdominal pain upper, Body temperature decreased, Muscle spasms — Feeling: Good · Abdominal pain
    Free 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 91
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-03-07
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-03-10
    Health check-in — day 7, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  17. 2021-03-17
    Survey response — day 14, dose 2
    MedDRA: Office visit, Rash — Feeling: Good · Get care from a doctor or other healthcare professional
    Free 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 doctor
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-03-17
    Report sent to call center — day 14, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  19. 2021-03-22
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-03-31
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-04-05
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-04-12
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-05-31
    Survey response — 3 months, dose 2
    MedDRA: Cough — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Cough, I feel good otherwise just take bad coughing spells.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  24. 2021-08-30
    Survey response — 6 months, dose 2
    MedDRA: Cough, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: Persistent cough · Healthcare visit (other): Doctors office
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  25. 2021-08-30
    Report sent to call center — 6 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  26. 2021-08-31
  27. 2022-03-01
    Survey response — 12 months, dose 2
    MedDRA: Foot fracture, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: Keep fracturing bones in feet. · Healthcare visit (other): Dr office
    MedDRA releases: 2024-11 · check-in free text available
  28. 2022-03-01
    Report sent to call center — 12 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  29. 2022-03-04
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

DoseDateManufacturerCo-administered
12021-02-01Moderna
22021-03-01Moderna

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-03-02

Systemic reaction (other): Tired

Release 5 — days 1–6 daily, dose 2

2021-03-05

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

2021-03-17

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

2021-05-31

Symptoms: Cough, I feel good otherwise just take bad coughing spells.

Release 9 — 6 months, dose 2

2021-08-30

Symptoms: Persistent cough
Healthcare visit (other): Doctors office

Release 11 — 12 months, dose 2

2022-03-01

Symptoms: Keep fracturing bones in feet.
Healthcare visit (other): Dr office

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

FieldPreferred term2021-092023-042024-11
HCVOOffice visit ✓ ✓ ✓
SDCough ✓ ✓ ✓
SDFoot fracture · · ✓
SDRash ✓ ✓ ✓
SROAbdominal pain upper ✓ ✓ ✓
SROBody temperature decreased ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROMuscle spasms ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release