4XK-15058-57663
1 vaccination
4 coded responses
14 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 307 / GA
- Registered
- 2021-01-15
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-15
Registered in v-safe
-
2021-01-15
Dose 1 — Moderna
- 2021-01-15
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2021-01-16
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
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2021-01-17
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
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2021-01-18
Survey response — days 1–6 daily, dose 1MedDRA: Abdominal pain — Feeling: Good · Site: Pain, Redness, Swelling · Abdominal painFree text: Abdominal cramps yesterday & today. Just noticed thatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-19
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Redness, Itching · NoneAdult check-in
- 2021-01-21
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2021-01-22
Survey response — day 7, dose 1MedDRA: Abdominal pain upper, Erythema, Injection site erythema, Injection site swelling, Pain, Swelling — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Abdominal painFree text: I only had the swelling, pain, redness for approximately 3 days. So I have been answering no (because I havent had any more since the first vaccine). I just wanted to clarify. And they were obviously worse the first two days & then it was better by the 4th day. Stomach cramps was mild & it lasted about 3 days. So far no issues since.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-29
- 2021-02-05
- 2021-02-17
- 2021-02-19
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2021-04-16
Survey response — 3 months, dose 1MedDRA: Chills, Headache, Influenza like illness, Pain, Pyrexia — Feeling: Good · Be unable to do your normal daily activitiesFree text: I had my 2nd Maderna shot 6wks after the 1st shot bc I had to go out of state & then facility couldnt give me the 2nd one on time. I had flu like symptoms started 12 hrs after the shot:chills,fever, body aches lasted 10 hrs& an awful headache.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-16
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2022-01-15
Survey response — 12 months, dose 1MedDRA: SARS-CoV-2 test positive — Feeling: Poor · Be unable to work or attend schoolFree text: Tested positive for covid 1/12/22.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-15 | Moderna |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Abdominal cramps yesterday & today. Just noticed that
Release 2 — day 7, dose 1
Systemic reaction (other): I only had the swelling, pain, redness for approximately 3 days. So I have been answering no (because I havent had any more since the first vaccine). I just wanted to clarify. And they were obviously worse the first two days & then it was better by the 4th day. Stomach cramps was mild & it lasted about 3 days. So far no issues since.
Release 7 — 3 months, dose 1
Symptoms: I had my 2nd Maderna shot 6wks after the 1st shot bc I had to go out of state & then facility couldnt give me the 2nd one on time. I had flu like symptoms started 12 hrs after the shot:chills,fever, body aches lasted 10 hrs& an awful headache.
Release 10 — 12 months, dose 1
Symptoms: Tested positive for covid 1/12/22.
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 | Chills | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Influenza like illness | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SRO | Abdominal pain | ✓ | ✓ | ✓ |
| SRO | Abdominal pain upper | ✓ | ✓ | ✓ |
| SRO | Erythema | · | · | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ○ |
| SRO | Injection site swelling | ✓ | ✓ | ○ |
| SRO | Pain | · | · | ✓ |
| SRO | Swelling | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release