4XZ-96471-71484
5 vaccinations
5 coded responses
48 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 786 / TX
- 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
- 2021-02-22
-
2021-02-27
Survey response — day 21, dose 1MedDRA: Back disorder, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Back issues · Healthcare visit (other): Regular in person doctor appointmentMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-27
Report sent to call center — day 21, dose 1Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-06
Dose 2 — Moderna
-
2021-03-07
Survey response — days 1–6 daily, dose 2MedDRA: Blepharospasm, Injection site paraesthesia, Paraesthesia, Sensory disturbance — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body achesFree text: Some peculiar sensations on my left side (injection in left arm). Left eye slight twitch, sensation of an tingling sensation down left calf to big toe, tingling in left upper arm near injection site. Only lasted a few hours from 9 to 20 hours after injection.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-08
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-09
- 2021-03-10
-
2021-03-11
Survey response — days 1–6 daily, dose 2MedDRA: Ear pain — Feeling: GoodFree text: Slight ear pain since the injection but doubt theres a correlation.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-12
- 2021-03-13
- 2021-03-20
- 2021-03-27
- 2021-04-03
- 2021-04-10
- 2021-04-17
- 2021-06-05
- 2021-09-04
-
2021-09-07
Dose 3 — Moderna
-
2021-09-08
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-09-08
-
2021-09-08
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-09-09
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body achesAdult check-in
-
2021-09-10
Health check-in — days 1–6 daily, dose 3Feeling: Good · Joint pains, Muscle or body achesAdult check-in
-
2021-09-11
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Itching · Muscle or body achesAdult check-in
- 2021-09-12
- 2021-09-13
- 2021-09-14
- 2021-09-22
- 2021-09-28
- 2021-10-05
- 2021-10-12
- 2021-10-19
- 2021-12-07
- 2022-03-08
-
2022-03-22
Dose 4 — Moderna
- 2022-04-14
- 2022-04-19
- 2022-04-26
- 2022-05-03
-
2022-06-21
Survey response — 3 months, dose 4MedDRA: Headache, Oropharyngeal pain — Feeling: Good · Be unable to do your normal daily activitiesFree text: Very sore throat, headacheMedDRA releases: 2024-11 · check-in free text available
-
2022-09-14
Dose 5 — Moderna
-
2022-09-14
Health check-in — day 0, dose 5Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body achesAdult check-in
-
2022-09-16
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2022-09-17
Survey response — days 1–6 daily, dose 5MedDRA: Headache — Feeling: Fair · Headache, Muscle or body achesFree text: No, just want to add the headache with this booster is terrible!MedDRA releases: 2024-11 · check-in free text available
- 2022-09-18
- 2022-09-19
- 2022-09-21
- 2022-09-28
- 2022-10-05
- 2022-10-12
- 2022-10-19
- 2022-10-26
- 2022-12-14
- 2023-03-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-06 | Moderna | |
| 2 | 2021-03-06 | Moderna | |
| 3 | 2021-09-07 | Moderna | No |
| 4 | 2022-03-22 | Moderna | No |
| 5 | 2022-09-14 | Moderna | No |
Call center
1 call center case
1 successful
1 wait over 3 months for a first call
Free text
Release 4 — day 21, dose 1
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Some peculiar sensations on my left side (injection in left arm). Left eye slight twitch, sensation of an tingling sensation down left calf to big toe, tingling in left upper arm near injection site. Only lasted a few hours from 9 to 20 hours after injection.
Systemic reaction (other): Slight ear pain since the injection but doubt theres a correlation.
Release 12 — 3 months, dose 4
Symptoms: Very sore throat, headache
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): No, just want to add the headache with this booster is terrible!
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 |
|---|---|---|---|---|
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SD | Back disorder | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SRO | Blepharospasm | ✓ | ✓ | ✓ |
| SRO | Ear pain | ✓ | ✓ | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Injection site paraesthesia | ✓ | ✓ | ✓ |
| SRO | Paraesthesia | ✓ | ✓ | ✓ |
| SRO | Sensory disturbance | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release