4VY-30529-61789
5 vaccinations
13 coded responses
61 check-ins
12 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 719 / AR
- Registered
- 2021-02-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-23
Dose 1 — Moderna
-
2021-02-01
Registered in v-safe
- 2021-02-01
- 2021-02-06
- 2021-02-13
- 2021-02-20
- 2021-02-27
-
2021-03-03
Dose 2 — Moderna
- 2021-03-03
-
2021-03-04
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: Good · Site: Pain · Headache, Muscle or body aches, NauseaFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
-
2021-03-17
Survey response — day 14, dose 2MedDRA: Contusion, Erythema, Pruritus, Skin irritation, Skin warm — Feeling: GoodFree text: 6 days after 2nd shot, hands and arms excessive itching, skin irritated and heated, redness of skin with lightly bruised appearance. Continued off and on for 3 days. Has completely cleared now.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
- 2021-03-31
-
2021-04-07
Survey response — day 35, dose 2MedDRA: Dizziness, Headache, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Headache, dizzy spell. Something I have occassionally. Not new.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-14
- 2021-06-02
- 2021-09-01
-
2021-10-29
Dose 3 — Moderna
-
2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Injection site pain — Feeling: Good · Site: SwellingFree text: Just soreness at injection siteMedDRA releases: 2024-11 · check-in free text available
- 2021-11-01
- 2021-11-02
-
2021-11-03
Health check-in — days 1–6 daily, dose 3Feeling: Good · Headache, Muscle or body achesAdult check-in
-
2021-11-04
Survey response — days 1–6 daily, dose 3MedDRA: Dyspnoea — Feeling: Good · HeadacheFree text: Some shortness of breathMedDRA releases: 2024-11 · check-in free text available
- 2021-11-05
- 2021-11-12
-
2021-11-19
Survey response — day 21, dose 3MedDRA: Respiratory tract congestion — Feeling: FairFree text: CongestionMedDRA releases: 2024-11 · check-in free text available
- 2021-11-26
-
2021-12-03
Survey response — day 35, dose 3MedDRA: Dyspnoea, Respiratory tract congestion — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Congestion, shortness of breathMedDRA releases: 2024-11 · check-in free text available
-
2021-12-03
Report sent to call center — day 35, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2021-12-07
-
2021-12-10
Survey response — day 42, dose 3MedDRA: Urinary tract infection — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: UTIMedDRA releases: 2024-11 · check-in free text available
-
2021-12-10
Report sent to call center — day 42, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2021-12-13
- 2022-01-28
- 2022-04-29
-
2022-05-20
Dose 4 — Moderna
-
2022-05-21
Health check-in — days 1–6 daily, dose 4Feeling: Good · Fever · Headache, Fatigue or tirednessAdult check-in
- 2022-05-22
-
2022-05-23
Health check-in — days 1–6 daily, dose 4Feeling: Good · Fatigue or tiredness, NauseaAdult check-in
- 2022-05-24
- 2022-05-25
- 2022-05-26
-
2022-05-27
Survey response — day 7, dose 4MedDRA: No adverse event — Feeling: Good · HeadacheFree text: NoMedDRA releases: 2024-11 · check-in free text available
- 2022-06-03
- 2022-06-10
- 2022-06-17
- 2022-06-24
- 2022-07-01
-
2022-08-19
Survey response — 3 months, dose 4MedDRA: Pre-existing disease, Respiratory tract congestion — Feeling: GoodFree text: Congestion (I have COPD and weather impacts me).MedDRA releases: 2024-11 · check-in free text available
-
2022-10-12
Dose 5 — ModernaCo-administered: Flu
- 2022-10-12
-
2022-10-13
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Fever · Headache, Fatigue or tirednessAdult check-in
-
2022-10-14
Health check-in — days 1–6 daily, dose 5Feeling: Good · Headache, Fatigue or tirednessAdult check-in
- 2022-10-15
- 2022-10-16
-
2022-10-17
Health check-in — days 1–6 daily, dose 5Feeling: Good · Headache, Fatigue or tirednessAdult check-in
- 2022-10-18
-
2022-10-19
Survey response — day 7, dose 5MedDRA: Headache, Self-medication — Feeling: Good · HeadacheFree text: Woke with headache took aspirin, headache gone now.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-26
- 2022-11-02
-
2022-11-09
Survey response — day 28, dose 5MedDRA: Dyspnoea, Respiratory tract congestion, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Congestion, shortness of breath · Healthcare visit (other): Script for antibioticMedDRA releases: 2024-11 · check-in free text available
-
2022-11-09
Report sent to call center — day 28, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-11-10
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-11-10
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-11-10
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-11-16
- 2022-11-23
- 2023-01-11
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2023-04-12
Survey response — 6 months, dose 5MedDRA: Large intestine perforation, Medical counselling — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationMedDRA releases: 2024-11
-
2023-04-12
Report sent to call center — 6 months, dose 5Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
-
2023-04-13
Call successfulNot applicable - Accidental Reporting
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-23 | Moderna | |
| 2 | 2021-03-03 | Moderna | |
| 3 | 2021-10-29 | Moderna | No |
| 4 | 2022-05-20 | Moderna | No |
| 5 | 2022-10-12 | Moderna | Flu |
Call center
4 call center cases
4 successful
Free text
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): No
Release 5 — day 14, dose 2
Symptoms: 6 days after 2nd shot, hands and arms excessive itching, skin irritated and heated, redness of skin with lightly bruised appearance. Continued off and on for 3 days. Has completely cleared now.
Release 7 — day 35, dose 2
Symptoms: Headache, dizzy spell. Something I have occassionally. Not new.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Just soreness at injection site
Systemic reaction (other): Some shortness of breath
Release 10 — day 21, dose 3
Symptoms: Congestion
Release 10 — day 35, dose 3
Symptoms: Congestion, shortness of breath
Release 10 — day 42, dose 3
Symptoms: UTI
Release 11 — day 7, dose 4
Systemic reaction (other): No
Release 12 — 3 months, dose 4
Symptoms: Congestion (I have COPD and weather impacts me).
Release 12 — day 7, dose 5
Systemic reaction (other): Woke with headache took aspirin, headache gone now.
Release 12 — day 28, dose 5
Symptoms: Congestion, shortness of breath
Healthcare visit (other): Script for antibiotic
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 | Unevaluable event | · | · | ✓ |
| SD | Contusion | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Erythema | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Large intestine perforation | · | · | ✓ |
| SD | Medical counselling | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Pruritus | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Skin irritation | ✓ | ✓ | ✓ |
| SD | Skin warm | ✓ | ✓ | ✓ |
| SD | Urinary tract infection | · | · | ✓ |
| SRO | Dyspnoea | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Self-medication | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release