4S9-66307-77632
4 vaccinations
5 coded responses
23 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 930 / CA
- Registered
- 2021-03-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-27
Dose 1 — Moderna
-
2021-03-27
Registered in v-safe
-
2021-03-27
Dose 2 — Moderna
-
2021-03-27
Health check-in — day 0, dose 2Feeling: Fair · Site: Swelling · Fatigue or tirednessAdult check-in
-
2021-03-28
Survey response — days 1–6 daily, dose 2MedDRA: Middle insomnia, Pain, Self-medication — Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: I ached enough after taking Tylenol that I woke up after three hours and couldnt get back to sleep for a couple of hours then slept to almost ten.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-29
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling · Fatigue or tirednessAdult check-in
-
2021-03-30
Survey response — days 1–6 daily, dose 2MedDRA: Injection site erythema — Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection siteFree text: I have redness next to but not at the injection site. Thats where it was red yesterday too.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-31
Survey response — days 1–6 daily, dose 2MedDRA: Erythema — Feeling: Fair · Site: Redness · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: I noticed both my husband and I had red areas not around the injection location but toward the front of the arm.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-02
Survey response — days 1–6 daily, dose 2MedDRA: Medical counselling, Rash — Feeling: GoodFree text: My husband is under doctors care for a rash he got four days after he got his shot. The doctor is not sure of the cause. It has expanded to at least 6 x6 and has started to wrap in the last two days.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-10
- 2021-04-17
- 2021-04-24
- 2021-05-01
- 2021-05-08
- 2021-06-26
- 2021-09-25
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2021-11-05
Dose 3 — Moderna
-
2022-03-27
Survey response — 12 months, dose 2MedDRA: Mass excision, Thoracic operation — Feeling: Fair · Get care from a doctor or other healthcare professional · HospitalizationFree text: I had thoracic surgery to remove a mass.MedDRA releases: 2024-11 · check-in free text available
-
2022-03-27
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalHospitalization · 1 call case(s)
-
2022-03-31
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-04-18
Dose 4 — Moderna
- 2022-04-27
- 2022-05-02
- 2022-05-09
- 2022-05-16
- 2022-05-23
- 2022-06-01
- 2022-07-20
- 2022-10-17
- 2023-04-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-27 | Moderna | |
| 2 | 2021-03-27 | Moderna | |
| 3 | 2021-11-05 | Moderna | No |
| 4 | 2022-04-18 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): I ached enough after taking Tylenol that I woke up after three hours and couldnt get back to sleep for a couple of hours then slept to almost ten.
Systemic reaction (other): I have redness next to but not at the injection site. Thats where it was red yesterday too.
Systemic reaction (other): I noticed both my husband and I had red areas not around the injection location but toward the front of the arm.
Systemic reaction (other): My husband is under doctors care for a rash he got four days after he got his shot. The doctor is not sure of the cause. It has expanded to at least 6 x6 and has started to wrap in the last two days.
Release 11 — 12 months, dose 2
Symptoms: I had thoracic surgery to remove a mass.
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 | Mass excision | · | · | ✓ |
| SD | Thoracic operation | · | · | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Medical counselling | ✓ | ✓ | ✓ |
| SRO | Middle insomnia | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release