4W5-11356-42616
4 vaccinations
7 coded responses
34 check-ins
7 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 784 / TX
- Registered
- 2021-01-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-11
Dose 1 — Moderna
-
2021-01-12
Registered in v-safe
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2021-01-12
Survey response — days 1–6 daily, dose 1MedDRA: Dyspnoea, Palpitations, Sleep disorder — Feeling: Good · Site: Pain · HeadacheFree text: Woke up at 12:30 with heart palpitations and slight shortness of breath. Couldn't go back to sleep for several hours although those symptoms only lasted for a short while.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-13
- 2021-01-14
- 2021-01-15
- 2021-01-16
- 2021-01-17
- 2021-01-18
- 2021-01-25
- 2021-02-01
- 2021-02-08
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2021-02-10
Dose 2 — Moderna
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2021-02-10
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint painsAdult check-in
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2021-02-11
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia, Back pain, Feeling abnormal, Sleep disorder — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to workFree text: I feel bad all over and my joints, especially my back, are hurting a lot. The pain in my back kept me awake last night.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-12
Survey response — days 1–6 daily, dose 2MedDRA: Back pain — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body achesFree text: Still have a lot of pain in my lower back.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-13
Survey response — days 1–6 daily, dose 2MedDRA: Back pain — Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches · Be unable to workFree text: Lower back is hurting. Pain is intense.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-14
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Joint pains, Muscle or body achesAdult check-in
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2021-02-15
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Joint pains, Muscle or body achesAdult check-in
-
2021-02-19
Health check-in — day 7, dose 2Feeling: Fair · Headache, Joint pains, Muscle or body achesAdult check-in
- 2021-02-25
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-05-12
- 2021-08-11
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2021-10-08
Dose 3 — Moderna
- 2021-10-25
-
2021-10-29
Survey response — day 21, dose 3MedDRA: Dyspnoea, Insomnia, Lethargy — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Shortness of breath, lethargic, insomniaMedDRA releases: 2024-11 · check-in free text available
- 2021-11-05
- 2021-11-12
- 2021-11-19
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2022-01-07
Survey response — 3 months, dose 3MedDRA: Cough, Discharge, Headache, Respiratory tract congestion, SARS-CoV-2 test positive — Feeling: Poor · Be unable to work or attend school, 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: Tested positive for covid. Congestion, coughing, headache, drainage.MedDRA releases: 2024-11 · check-in free text available
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2022-01-07
Report sent to call center — 3 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
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2022-01-12
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-04-08
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2022-06-20
Dose 4 — Moderna
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2022-06-23
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Redness · Headache, Joint painsAdult check-in
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2022-12-19
Survey response — 6 months, dose 4MedDRA: COVID-19, Fatigue, Respiratory disorder, SARS-CoV-2 test negative — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Covid positive on 26-Nov-2022. Now negative but my health is worse. Severe breathing issues and fatigue.MedDRA releases: 2024-11 · check-in free text available
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2022-12-19
Report sent to call center — 6 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-12-20
- 2023-06-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-11 | Moderna | |
| 2 | 2021-02-10 | Moderna | |
| 3 | 2021-10-08 | Moderna | No |
| 4 | 2022-06-20 | Moderna | No |
Call center
2 call center cases
1 successful · 1 unsuccessful
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Woke up at 12:30 with heart palpitations and slight shortness of breath. Couldn't go back to sleep for several hours although those symptoms only lasted for a short while.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): I feel bad all over and my joints, especially my back, are hurting a lot. The pain in my back kept me awake last night.
Systemic reaction (other): Still have a lot of pain in my lower back.
Systemic reaction (other): Lower back is hurting. Pain is intense.
Release 10 — day 21, dose 3
Symptoms: Shortness of breath, lethargic, insomnia
Release 10 — 3 months, dose 3
Symptoms: Tested positive for covid. Congestion, coughing, headache, drainage.
Release 12 — 6 months, dose 4
Symptoms: Covid positive on 26-Nov-2022. Now negative but my health is worse. Severe breathing issues and fatigue.
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 | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Discharge | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Insomnia | · | · | ✓ |
| SD | Lethargy | · | · | ✓ |
| SD | Respiratory disorder | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Palpitations | ✓ | ✓ | ✓ |
| SRO | Sleep disorder | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release