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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

  1. 2021-04-03
    Dose 1 — Janssen/Johnson & Johnson
  2. 2021-04-07
    Registered in v-safe
  3. 2021-04-07
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Muscle or body aches, Diarrhea, Abdominal pain
    Adult check-in
  4. 2021-04-08
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness, Diarrhea
    Adult check-in
  5. 2021-04-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-04-10
    Health check-in — day 7, dose 1
    Feeling: Good · Diarrhea
    Adult check-in
  7. 2021-04-17
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  8. 2021-04-24
    Survey response — day 21, single dose
    MedDRA: Nasal congestion, Oropharyngeal pain, Pre-existing disease — Feeling: Good
    Free 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 occasional
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-05-01
    Survey response — day 28, single dose
    MedDRA: Menstruation delayed — Feeling: Good
    Free text: Delayed period.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-05-08
    Health check-in — day 35, single dose
    Feeling: Good
    Adult check-in
  11. 2021-05-15
    Health check-in — day 42, single dose
    Feeling: Good
    Adult check-in
  12. 2021-07-03
    Health check-in — 3 months, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-10-02
    Survey response — 6 months, dose 1
    MedDRA: Reaction to previous exposure to any vaccine, Sensory disturbance — Feeling: Good
    Free 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
  14. 2021-10-24
    Dose 2 — Moderna
  15. 2021-10-31
    Health check-in — day 7, dose 2
    Feeling: Good · Headache
    Adult check-in
  16. 2021-11-07
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-11-14
    Health check-in — day 21, dose 2
    Feeling: Fair
    Adult check-in
  18. 2021-11-21
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-11-28
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-12-05
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  21. 2022-01-23
    Survey response — 3 months, dose 2
    MedDRA: Influenza — Feeling: Good · Be unable to do your normal daily activities
    Free 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
  22. 2022-04-24
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  23. 2022-10-24
    Survey response — 12 months, dose 2
    MedDRA: 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 activities
    Free 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

DoseDateManufacturerCo-administered
12021-04-03Janssen/Johnson & Johnson
22021-10-24Moderna No

Free text

Release 7 — day 21, single dose

2021-04-24

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

2021-05-01

Symptoms: Delayed period.

Release 9 — 6 months, dose 1

2021-10-02

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

2022-01-23

Symptoms: I think I had the flu. Had multiple negative rapid tests and no known exposure.

Release 12 — 12 months, dose 2

2022-10-24

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

FieldPreferred term2021-092023-042024-11
SDCOVID-19 · · ✓
SDCroup infectious · · ✓
SDInfluenza · · ✓
SDMenstruation delayed ✓ ✓ ✓
SDNasal congestion ✓ ✓ ✓
SDOropharyngeal pain ✓ ✓ ✓
SDPre-existing disease ✓ ✓ ✓
SDReaction to previous exposure to any vaccine · · ✓
SDSensory disturbance · · ✓
SDUpper respiratory tract infection · · ✓

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