4SG-10935-02998
2 vaccinations
5 coded responses
20 check-ins
5 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 530 / WI
- Registered
- 2021-04-07
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-03
Dose 1 — Janssen/Johnson & Johnson
-
2021-04-07
Registered in v-safe
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2021-04-07
Health check-in — days 1–6 daily, dose 1Feeling: Good · Muscle or body aches, Diarrhea, Abdominal painAdult check-in
-
2021-04-08
Health check-in — days 1–6 daily, dose 1Feeling: Good · Fatigue or tiredness, DiarrheaAdult check-in
- 2021-04-09
- 2021-04-10
- 2021-04-17
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2021-04-24
Survey response — day 21, single doseMedDRA: Nasal congestion, Oropharyngeal pain, Pre-existing disease — Feeling: GoodFree text: Im sure its allergies because Im highly allergic to mold, my house is waterfront, and its been on & off rainy. Its too hot for heat, too cold for AC, so my windows are often open. I have nasal congestion, a sore throat, and occasionalMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-01
Survey response — day 28, single doseMedDRA: Menstruation delayed — Feeling: GoodFree text: Delayed period.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-08
- 2021-05-15
- 2021-07-03
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2021-10-02
Survey response — 6 months, dose 1MedDRA: Reaction to previous exposure to any vaccine, Sensory disturbance — Feeling: GoodFree text: After I heard about the risk for Guillain Barre I connected that the strange sensation of warm running water down the outside of my right thigh was from the vaccine. I had this in 2008 or 2009 after a swine flu shot. MRI & CT scan normal then.MedDRA releases: 2024-11 · check-in free text available
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2021-10-24
Dose 2 — Moderna
- 2021-10-31
- 2021-11-07
- 2021-11-14
- 2021-11-21
- 2021-11-28
- 2021-12-05
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2022-01-23
Survey response — 3 months, dose 2MedDRA: Influenza — Feeling: Good · Be unable to do your normal daily activitiesFree text: I think I had the flu. Had multiple negative rapid tests and no known exposure.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-24
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2022-10-24
Survey response — 12 months, dose 2MedDRA: COVID-19, Croup infectious, Influenza, Upper respiratory tract infection — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: I've had a series of upper respiratory infections since my children started preschool & kindergarten. Including Covid, croup, and influenza.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-03 | Janssen/Johnson & Johnson | |
| 2 | 2021-10-24 | Moderna | No |
Free text
Release 7 — day 21, single dose
Symptoms: Im sure its allergies because Im highly allergic to mold, my house is waterfront, and its been on & off rainy. Its too hot for heat, too cold for AC, so my windows are often open. I have nasal congestion, a sore throat, and occasional
Release 8 — day 28, single dose
Symptoms: Delayed period.
Release 9 — 6 months, dose 1
Symptoms: After I heard about the risk for Guillain Barre I connected that the strange sensation of warm running water down the outside of my right thigh was from the vaccine. I had this in 2008 or 2009 after a swine flu shot. MRI & CT scan normal then.
Release 11 — 3 months, dose 2
Symptoms: I think I had the flu. Had multiple negative rapid tests and no known exposure.
Release 12 — 12 months, dose 2
Symptoms: I've had a series of upper respiratory infections since my children started preschool & kindergarten. Including Covid, croup, and influenza.
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 | COVID-19 | · | · | ✓ |
| SD | Croup infectious | · | · | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Menstruation delayed | ✓ | ✓ | ✓ |
| SD | Nasal congestion | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Reaction to previous exposure to any vaccine | · | · | ✓ |
| SD | Sensory disturbance | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release