4XR-14197-71651
4 vaccinations
5 coded responses
53 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 590 / MT
- Registered
- 2021-01-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-28
Registered in v-safe
-
2021-01-28
Dose 1 — Moderna
- 2021-01-28
- 2021-01-29
-
2021-01-31
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-11
-
2021-02-18
Survey response — day 21, dose 1MedDRA: Fatigue, Headache — Feeling: FairFree text: Feeling very tired; have a persistent headacheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-25
Dose 2 — Moderna
- 2021-02-25
-
2021-02-26
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-04-01
- 2021-04-08
- 2021-05-27
- 2021-08-26
-
2021-10-25
Dose 3 — Moderna
-
2021-10-25
Survey response — day 0, dose 3MedDRA: Injection site pain — Feeling: GoodFree text: Slight ache where the shot was receivedMedDRA releases: 2024-11 · check-in free text available
-
2021-10-26
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-10-27
Survey response — days 1–6 daily, dose 3MedDRA: Cystitis — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: I have developed a bladder infection. How I feel today is not connected to the vaccine.MedDRA releases: 2024-11 · check-in free text available
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-08
-
2021-11-15
Survey response — day 21, dose 3MedDRA: Office visit, Pruritus, Salivary gland enlargement — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: The large saliva glands in front of my ears that wrap under my jaw began to swell and itch inexplicably. It was so unusual that I went to urgent care. No pain, just intense itching and a big lump on both sides. Am taking antibiotics and prednisone.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-15
Report sent to call center — day 21, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-11-16
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2022-01-24
-
2022-04-14
Dose 4 — Moderna
-
2022-04-15
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2022-04-16
Survey response — days 1–6 daily, dose 4MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2024-11 · check-in free text available
- 2022-04-17
- 2022-04-18
- 2022-04-19
- 2022-04-20
- 2022-04-21
- 2022-04-28
- 2022-05-05
- 2022-05-12
- 2022-05-19
- 2022-05-26
- 2022-07-14
- 2022-10-13
- 2023-04-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-28 | Moderna | |
| 2 | 2021-02-25 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-04-14 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 4 — day 21, dose 1
Symptoms: Feeling very tired; have a persistent headache
Release 10 — day 0, dose 3
Systemic reaction (other): Slight ache where the shot was received
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): I have developed a bladder infection. How I feel today is not connected to the vaccine.
Release 10 — day 21, dose 3
Symptoms: The large saliva glands in front of my ears that wrap under my jaw began to swell and itch inexplicably. It was so unusual that I went to urgent care. No pain, just intense itching and a big lump on both sides. Am taking antibiotics and prednisone. cut off by CDC
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): No
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 | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pruritus | · | · | ✓ |
| SD | Salivary gland enlargement | · | · | ✓ |
| SRO | Cystitis | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | No adverse event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release