4TT-13191-44296
5 vaccinations
12 coded responses
37 check-ins
12 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 600 / IL
- Registered
- 2021-03-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-02
Dose 1 — Moderna
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2021-03-31
Registered in v-safe
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2021-03-31
Dose 2 — Moderna
- 2021-03-31
-
2021-04-01
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: GoodFree text: None. No reaction at allMedDRA 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: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-03
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: GoodFree text: No, I am starting to doubt I actually got the vaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-04
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-05
Survey response — days 1–6 daily, dose 2MedDRA: SARS-CoV-2 test — Feeling: GoodFree text: Had a Covid test todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-06
Survey response — days 1–6 daily, dose 2MedDRA: SARS-CoV-2 test negative — Feeling: GoodFree text: Had a Covid test Monday and it was negative. Surgery on April 8thMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-07
Survey response — day 7, dose 2MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-14
Survey response — day 14, dose 2MedDRA: Diarrhoea, Hip arthroplasty — Feeling: GoodFree text: I have had diarrhea for the past three days. It could be from the new medications that I am taking. I had hip replacement surgery on April 8th.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-21
- 2021-04-28
- 2021-05-05
- 2021-05-12
- 2021-06-30
- 2021-09-30
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2021-11-05
Dose 3 — Moderna
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2022-03-31
Survey response — 12 months, dose 2MedDRA: Breast cancer, Breast conserving surgery, Hip arthroplasty, Knee arthroplasty, Pre-existing disease, Radiotherapy — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, HospitalizationFree text: Symptoms: My breast cancer came back. I have had two lumpectomies and 20 radiation treatments. Also a hip and knee replacement · Healthcare visit (other): Radiation was outpatient. Hip and knee replacements hospitalMedDRA releases: 2024-11 · check-in free text available
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2022-03-31
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
- 2022-04-05
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2022-05-02
Dose 4 — Moderna
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2022-05-02
Survey response — day 0, dose 4MedDRA: Breast cancer, Pre-existing disease, Radiotherapy — Feeling: GoodFree text: I had 4 weeks of radiation from my reoccurring breast cancerMedDRA releases: 2024-11 · check-in free text available
- 2022-05-03
- 2022-05-04
- 2022-05-05
- 2022-05-06
- 2022-05-07
- 2022-05-08
- 2022-05-09
- 2022-05-16
- 2022-05-23
- 2022-05-30
- 2022-06-06
- 2022-06-13
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2022-08-01
Survey response — 3 months, dose 4MedDRA: Medical procedure, SARS-CoV-2 test negative — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, HospitalizationFree text: I had two procedures on July 28th and 29th that account for me feeling fair. I am recovering from those procedures. I had a covid PCR test that was negative before the proceduresMedDRA releases: 2024-11 · check-in free text available
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2022-08-01
Report sent to call center — 3 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
- 2022-08-02
- 2022-08-02
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2022-09-14
Dose 5 — Moderna
- 2022-10-02
- 2022-10-05
- 2022-10-12
- 2022-10-19
- 2022-10-26
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2022-12-14
Survey response — 3 months, dose 5MedDRA: Bone operation, Exposure to SARS-CoV-2, Fall, Femur fracture, SARS-CoV-2 test positive — Feeling: FairFree text: I fell and shattered my femur while I was visiting my son's in California. I had to have major surgery on my femur and I am still in California recovery. My 2 son's came down with covid , one of them has long term Covid. I tested positive for covidMedDRA releases: 2024-11 · check-in free text available
- 2023-03-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-02 | Moderna | |
| 2 | 2021-03-31 | Moderna | |
| 3 | 2021-11-05 | Moderna | No |
| 4 | 2022-05-02 | Moderna | No |
| 5 | 2022-09-14 | Moderna | No |
Call center
2 call center cases
2 unsuccessful
Free text
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): None. No reaction at all
Systemic reaction (other): No
Systemic reaction (other): No, I am starting to doubt I actually got the vaccine
Systemic reaction (other): No
Systemic reaction (other): Had a Covid test today
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Had a Covid test Monday and it was negative. Surgery on April 8th
Release 7 — day 7, dose 2
Systemic reaction (other): No
Release 7 — day 14, dose 2
Symptoms: I have had diarrhea for the past three days. It could be from the new medications that I am taking. I had hip replacement surgery on April 8th.
Release 11 — 12 months, dose 2
Symptoms: My breast cancer came back. I have had two lumpectomies and 20 radiation treatments. Also a hip and knee replacement
Healthcare visit (other): Radiation was outpatient. Hip and knee replacements hospital
Release 11 — day 0, dose 4
Systemic reaction (other): I had 4 weeks of radiation from my reoccurring breast cancer
Release 12 — 3 months, dose 4
Symptoms: I had two procedures on July 28th and 29th that account for me feeling fair. I am recovering from those procedures. I had a covid PCR test that was negative before the procedures
Release 12 — 3 months, dose 5
Symptoms: I fell and shattered my femur while I was visiting my son's in California. I had to have major surgery on my femur and I am still in California recovery. My 2 son's came down with covid , one of them has long term Covid. I tested positive for covid cut off by CDC
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 | Hip arthroplasty | · | · | ✓ |
| HCVO | Knee arthroplasty | · | · | ✓ |
| HCVO | Radiotherapy | · | · | ✓ |
| SD | Bone operation | · | · | ✓ |
| SD | Breast cancer | · | · | ✓ |
| SD | Breast conserving surgery | · | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Fall | · | · | ✓ |
| SD | Femur fracture | · | · | ✓ |
| SD | Hip arthroplasty | ✓ | ✓ | ✓ |
| SD | Knee arthroplasty | · | · | ✓ |
| SD | Medical procedure | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Radiotherapy | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Breast cancer | · | · | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Radiotherapy | · | · | ✓ |
| SRO | SARS-CoV-2 test | ✓ | ✓ | ✓ |
| SRO | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release