4T3-34588-32069
3 vaccinations
3 coded responses
34 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 068 / CT
- Registered
- 2021-01-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-27
Dose 1 — Moderna
-
2021-01-29
Registered in v-safe
- 2021-01-29
- 2021-01-30
- 2021-02-01
- 2021-02-02
- 2021-02-12
- 2021-02-18
-
2021-02-26
Dose 2 — Moderna
- 2021-02-26
-
2021-02-27
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue — Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tirednessFree text: These symptoms occurred last night but today only feeling tired.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-04-03
- 2021-04-13
- 2021-05-28
-
2021-08-27
Survey response — 6 months, dose 2MedDRA: Amnesia, Laboratory test abnormal, Myocardial infarction, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Symptoms: I had an episode of temporary amnesia in late June and have been undergoing tests since to determine cause. Results indicate no Neurological problems, but a moderate myocardial infarction is indicated. Stress Ultra sound will follow this week. · Healthcare visit (other): Specialists visits- neurologist, cardiologistMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-27
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-10-07
-
2021-10-28
Dose 3 — Moderna
- 2021-10-28
- 2021-10-29
- 2021-10-30
-
2021-11-01
Survey response — days 1–6 daily, dose 3MedDRA: Fatigue, Somnolence — Feeling: GoodFree text: The day after I received my shot, I was exhausted after 10 hrs sleep The previous night. I took a three hour nap that afternoon, something very unusual for me. (I did not see any place to include this information, so adding it now.)MedDRA releases: 2024-11 · check-in free text available
- 2021-11-04
- 2021-11-11
- 2021-11-18
- 2021-11-27
- 2021-12-04
- 2021-12-09
- 2022-01-27
- 2022-04-28
- 2022-10-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-27 | Moderna | |
| 2 | 2021-02-26 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): These symptoms occurred last night but today only feeling tired.
Release 9 — 6 months, dose 2
Symptoms: I had an episode of temporary amnesia in late June and have been undergoing tests since to determine cause. Results indicate no Neurological problems, but a moderate myocardial infarction is indicated. Stress Ultra sound will follow this week.
Healthcare visit (other): Specialists visits- neurologist, cardiologist
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): The day after I received my shot, I was exhausted after 10 hrs sleep The previous night. I took a three hour nap that afternoon, something very unusual for me. (I did not see any place to include this information, so adding it now.)
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 |
|---|---|---|---|---|
| HCVO | Office visit | ✓ | · | ✓ |
| SD | Amnesia | ✓ | · | ✓ |
| SD | Laboratory test abnormal | ✓ | · | ✓ |
| SD | Myocardial infarction | ✓ | · | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Somnolence | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release