4SV-28969-06245
2 vaccinations
6 coded responses
22 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 989 / WA
- Registered
- 2021-01-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-22
Dose 1 — Moderna
-
2021-01-26
Registered in v-safe
-
2021-01-26
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-01-27
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2021-01-28
Survey response — days 1–6 daily, dose 1MedDRA: Pruritus, Rash — Feeling: Fair · ChillsFree text: Itching both my arms last 3 days... then small bumps arise. I have to take allergy pills to stop the itching.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-29
- 2021-02-05
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2021-02-12
Survey response — day 21, dose 1MedDRA: Chills, Decreased appetite, Nausea, Pain, Pyrexia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Put in my stomach... couldnt eat for like 26 hours. Low grade fever, chills, body aches slight nausea.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-19
Dose 2 — Moderna
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2021-02-19
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
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2021-02-20
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
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2021-02-21
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-02-22
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-02-23
- 2021-02-24
- 2021-02-25
- 2021-02-26
- 2021-03-05
- 2021-03-12
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2021-03-19
Survey response — day 28, dose 2MedDRA: Headache, Oropharyngeal pain, Respiratory tract congestion — Feeling: FairFree text: Headache, congestion, sore throat.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-26
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2021-04-02
Survey response — day 42, dose 2MedDRA: Back pain, Fatigue, Oropharyngeal pain, Rhinorrhoea — Feeling: FairFree text: Sore throat- runny nose. TirednessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-21
Survey response — 3 months, dose 2MedDRA: Cough, Headache, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea — Feeling: Fair · Be unable to work, Be unable to do your normal daily activitiesFree text: Sore throat, headache, congestion, runny nose, coughMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-08-22
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2022-02-19
Survey response — 12 months, dose 2MedDRA: Cough, Eye discharge, Pain, Rhinorrhoea — Feeling: Poor · Be unable to work or attend schoolFree text: Horrible cough. Body aches everywhere. Nasal drainage. Eye mucous both eyes!MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-22 | Moderna | |
| 2 | 2021-02-19 | Moderna |
Free text
Release 3 — days 1–6 daily, dose 1
Systemic reaction (other): Itching both my arms last 3 days... then small bumps arise. I have to take allergy pills to stop the itching.
Release 4 — day 21, dose 1
Symptoms: Put in my stomach... couldnt eat for like 26 hours. Low grade fever, chills, body aches slight nausea.
Release 5 — day 28, dose 2
Symptoms: Headache, congestion, sore throat.
Release 6 — day 42, dose 2
Symptoms: Sore throat- runny nose. Tiredness
Release 8 — 3 months, dose 2
Symptoms: Sore throat, headache, congestion, runny nose, cough
Release 11 — 12 months, dose 2
Symptoms: Horrible cough. Body aches everywhere. Nasal drainage. Eye mucous both eyes!
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 | Back pain | ✓ | ✓ | ○ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Decreased appetite | ✓ | ✓ | ✓ |
| SD | Eye discharge | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release