4WC-28210-84515
5 vaccinations
15 coded responses
50 check-ins
14 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 920 / CA
- Registered
- 2021-02-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-06
Registered in v-safe
-
2021-02-06
Dose 1 — Moderna
- 2021-02-20
- 2021-02-27
- 2021-03-06
-
2021-03-07
Dose 2 — Moderna
-
2021-03-07
Survey response — day 0, dose 2MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-08
Survey response — days 1–6 daily, dose 2MedDRA: Headache, Self-medication — Feeling: Good · Site: Pain · HeadacheFree text: Headache may be allergy related. It got better when I took antihistamine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-09
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: Good · Site: PainFree text: MoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-10
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: Good · Site: PainFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-11
Survey response — days 1–6 daily, dose 2MedDRA: Sneezing — Feeling: Good · Fatigue or tirednessFree text: Sneezing-probably allergy relatedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-13
-
2021-03-14
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
- 2021-03-21
-
2021-03-28
Survey response — day 21, dose 2MedDRA: Abdominal pain upper, Flatulence, Vomiting — Feeling: GoodFree text: Stomach pain / gas and vomiting - 1 episode of each on Friday night. Very likely something I ate. No problems since then.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-04
- 2021-04-11
- 2021-04-18
- 2021-06-06
-
2021-09-05
Survey response — 6 months, dose 2MedDRA: Headache, Rhinorrhoea — Feeling: GoodFree text: Mild headache and runny nose for about 2 days last month.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-10-24
Dose 3 — Moderna
- 2021-10-25
- 2021-10-26
-
2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: Vision blurred — Feeling: GoodFree text: Slight, transient blurred vision- may be allergy relatedMedDRA releases: 2024-11 · check-in free text available
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-07
- 2021-11-14
- 2021-11-21
-
2021-11-28
Survey response — day 35, dose 3MedDRA: Nasal congestion, Pre-existing disease — Feeling: FairFree text: Nasal congestion for 2 days probably due to weather change, allergiesMedDRA releases: 2024-11 · check-in free text available
- 2021-12-05
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2022-01-23
Survey response — 3 months, dose 3MedDRA: Cough, Dry eye, Eye pruritus, Insomnia, Respiratory tract congestion, Rhinorrhoea, Sneezing — Feeling: FairFree text: Cough, runny nose, sneezing, itchy dry eyes, trouble sleeping, head congestionMedDRA releases: 2024-11 · check-in free text available
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2022-04-12
Dose 4 — Moderna
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2022-04-14
Survey response — days 1–6 daily, dose 4MedDRA: Pre-existing disease, Respiratory tract congestion — Feeling: Good · Site: PainFree text: Head congestion / allergiesMedDRA releases: 2024-11 · check-in free text available
- 2022-04-15
- 2022-04-16
- 2022-04-17
- 2022-04-18
- 2022-04-19
- 2022-04-26
- 2022-05-03
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2022-05-10
Survey response — day 28, dose 4MedDRA: Tachycardia — Feeling: GoodFree text: Tachycardia episode lasting a few hoursMedDRA releases: 2024-11 · check-in free text available
- 2022-05-17
- 2022-05-24
- 2022-07-12
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2022-09-25
Dose 5 — Moderna
- 2022-10-11
- 2022-10-11
- 2022-10-18
- 2022-10-23
- 2022-10-30
-
2022-11-06
Survey response — day 42, dose 5MedDRA: Cough — Feeling: FairFree text: Intermittent coughingMedDRA releases: 2024-11 · check-in free text available
- 2022-12-25
-
2023-03-26
Survey response — 6 months, dose 5MedDRA: Cough, Pre-existing disease, Respiratory tract congestion, Sneezing — Feeling: FairMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-06 | Moderna | |
| 2 | 2021-03-07 | Moderna | |
| 3 | 2021-10-24 | Moderna | No |
| 4 | 2022-04-12 | Moderna | No |
| 5 | 2022-09-25 | Moderna | No |
Free text
Release 5 — day 0, dose 2
Systemic reaction (other): No
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Headache may be allergy related. It got better when I took antihistamine.
Systemic reaction (other): Mo
Systemic reaction (other): No
Systemic reaction (other): Sneezing-probably allergy related
Release 5 — day 7, dose 2
Systemic reaction (other): No
Release 6 — day 21, dose 2
Symptoms: Stomach pain / gas and vomiting - 1 episode of each on Friday night. Very likely something I ate. No problems since then.
Release 9 — 6 months, dose 2
Symptoms: Mild headache and runny nose for about 2 days last month.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Slight, transient blurred vision- may be allergy related
Release 10 — day 35, dose 3
Symptoms: Nasal congestion for 2 days probably due to weather change, allergies
Release 11 — 3 months, dose 3
Symptoms: Cough, runny nose, sneezing, itchy dry eyes, trouble sleeping, head congestion
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Head congestion / allergies
Release 11 — day 28, dose 4
Symptoms: Tachycardia episode lasting a few hours
Release 12 — day 42, dose 5
Symptoms: Intermittent coughing
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 | Abdominal pain upper | ✓ | ✓ | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Dry eye | · | · | ✓ |
| SD | Eye pruritus | · | · | ✓ |
| SD | Flatulence | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | · | ✓ |
| SD | Insomnia | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | ✓ | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SD | Tachycardia | · | · | ✓ |
| SD | Vomiting | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
| SRO | Respiratory tract congestion | · | · | ✓ |
| SRO | Self-medication | ✓ | ✓ | ○ |
| SRO | Sneezing | ✓ | ✓ | ✓ |
| SRO | Vision blurred | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release