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4XX-12665-30975

3 vaccinations 6 coded responses 26 check-ins 6 free-text entries 2 call cases
Sex
Female
Age at first dose
56-60
ZIP prefix
781 / TX
Registered
2021-03-09
Relationship
Self
Race
Black or African American
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-09
    Registered in v-safe
  2. 2021-03-09
    Dose 1 — Moderna
  3. 2021-03-09
    Survey response — day 0, dose 1
    MedDRA: Injection site pain, Myalgia — Feeling: Good
    Free text: Muscle soreness around injection site
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-10
    Survey response — days 1–6 daily, dose 1
    MedDRA: Dizziness — Feeling: Good · Site: Pain · Chills, Muscle or body aches
    Free text: Dizziness
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-12
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-03-13
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-03-14
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-03-15
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-03-18
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-03-23
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-03-30
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-04-06
    Dose 2 — Moderna
  13. 2021-04-06
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  14. 2021-04-07
    Survey response — days 1–6 daily, dose 2
    MedDRA: Chest pain, Dizziness, Rhinorrhoea, Throat irritation — Feeling: Good · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: Mid chest pain, irritation of throat, runny nose, dizziness
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-04-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-04-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-04-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  18. 2021-04-11
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-04-12
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-04-13
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  21. 2021-04-20
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-04-27
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-05-04
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-05-11
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-05-18
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-07-06
    Survey response — 3 months, dose 2
    MedDRA: Abdominal discomfort, Nausea, Pancreatitis, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Symptoms related to my pancreatitis, abdominal discomfort, nausea - Symptoms not related to covid 19
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  27. 2021-07-06
    Report sent to call center — 3 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  28. 2021-07-09
  29. 2021-10-05
    Survey response — 6 months, dose 2
    MedDRA: Alopecia, Tinnitus — Feeling: Good
    Free text: Ringing in one ear. Mild Hair loss
    MedDRA releases: 2024-11 · check-in free text available
  30. 2021-11-12
    Dose 3 — Moderna
  31. 2022-04-08
    Survey response — 12 months, dose 2
    MedDRA: Condition aggravated, Headache, Large intestinal polypectomy, Neuropathy peripheral, Pancreatitis, Pre-existing disease, Tooth disorder — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Some dental problems, inflammation of pancreas, removal polyps from colin, flare up of GERD,flare up of sinus cavity, allergies, headaches, increase of neuropathy on right side
    MedDRA releases: 2024-11 · check-in free text available
  32. 2022-04-08
    Report sent to call center — 12 months, dose 2
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  33. 2022-04-11
  34. 2022-05-15
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-09Moderna
22021-04-06Moderna
32021-11-12Moderna No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 5 — day 0, dose 1

2021-03-09

Systemic reaction (other): Muscle soreness around injection site

Release 5 — days 1–6 daily, dose 1

2021-03-10

Systemic reaction (other): Dizziness

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): Mid chest pain, irritation of throat, runny nose, dizziness

Release 9 — 3 months, dose 2

2021-07-06

Symptoms: Symptoms related to my pancreatitis, abdominal discomfort, nausea - Symptoms not related to covid 19

Release 10 — 6 months, dose 2

2021-10-05

Symptoms: Ringing in one ear. Mild Hair loss

Release 11 — 12 months, dose 2

2022-04-08

Symptoms: Some dental problems, inflammation of pancreas, removal polyps from colin, flare up of GERD,flare up of sinus cavity, allergies, headaches, increase of neuropathy on right side

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

FieldPreferred term2021-092023-042024-11
SDAbdominal discomfort ✓ ✓ ✓
SDAlopecia · · ✓
SDCondition aggravated · · ✓
SDHeadache · · ✓
SDLarge intestinal polypectomy · · ✓
SDNausea ✓ ✓ ✓
SDNeuropathy peripheral · · ✓
SDPancreatitis ✓ ✓ ✓
SDPre-existing disease ✓ ✓ ✓
SDTinnitus · · ✓
SDTooth disorder · · ✓
SROChest pain ✓ ✓ ✓
SRODizziness ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SROMyalgia ✓ ✓ ✓
SRORhinorrhoea ✓ ✓ ✓
SROThroat irritation ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release

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