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4YX-20019-84373

2 vaccinations 6 coded responses 15 check-ins 6 free-text entries 1 call case
Sex
Female
Age at first dose
51-55
ZIP prefix
606 / IL
Registered
2021-03-04
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-11
    Dose 1 — Moderna
  2. 2021-03-04
    Registered in v-safe
  3. 2021-03-04
    Survey response — day 21, dose 1
    MedDRA: Diarrhoea, Fatigue, Injection site erythema, Injection site pruritus, Injection site rash, Pruritus — Feeling: Good
    Free text: Rash at injection site about 5-7 days after vaccine, 3 in diameter, red, slightly itchy. Also, fatigue and diarrhea.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-11
    Dose 2 — Moderna
  5. 2021-03-11
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  6. 2021-03-12
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Redness · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities
    Adult check-in
  7. 2021-03-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  8. 2021-03-14
    Survey response — days 1–6 daily, dose 2
    MedDRA: Lung disorder, Productive cough — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: My lungs don't feel well, coughing up some mucus.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-03-15
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pulmonary pain — Feeling: Fair · Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities
    Free text: My lungs hurt
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-03-16
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Diarrhea
    Adult check-in
  11. 2021-03-17
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  12. 2021-03-18
    Survey response — day 7, dose 2
    MedDRA: COVID-19, Pre-existing disease, SARS-CoV-2 antibody test positive — Feeling: Good
    Free text: I did want to add that I have the MTHFR gene mutation, and had I what I believe to be Covid-19 a year ago, before testing was available. I did test positive for antibodies.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-03-25
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-04-01
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-04-08
    Survey response — day 28, dose 2
    MedDRA: Chills, Fatigue, Headache, Lymphadenopathy, Myalgia, Oropharyngeal pain — Feeling: Fair
    Free text: Fatigue, sore throat, chills, headache, muscle soreness, also swollen lymph nodes.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-04-15
    Health check-in — day 35, dose 2
    Feeling: Fair
    Adult check-in
  17. 2021-04-22
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-09-09
    Survey response — 6 months, dose 2
    MedDRA: Diarrhoea — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Diarrhea
    MedDRA releases: 2024-11 · check-in free text available
  19. 2021-09-09
    Report sent to call center — 6 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  20. 2021-09-15
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

DoseDateManufacturerCo-administered
12021-02-11Moderna
22021-03-11Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 5 — day 21, dose 1

2021-03-04

Symptoms: Rash at injection site about 5-7 days after vaccine, 3 in diameter, red, slightly itchy. Also, fatigue and diarrhea.

Release 5 — days 1–6 daily, dose 2

2021-03-14

Systemic reaction (other): My lungs don't feel well, coughing up some mucus.

2021-03-15

Systemic reaction (other): My lungs hurt

Release 5 — day 7, dose 2

2021-03-18

Systemic reaction (other): I did want to add that I have the MTHFR gene mutation, and had I what I believe to be Covid-19 a year ago, before testing was available. I did test positive for antibodies.

Release 7 — day 28, dose 2

2021-04-08

Symptoms: Fatigue, sore throat, chills, headache, muscle soreness, also swollen lymph nodes.

Release 9 — 6 months, dose 2

2021-09-09

Symptoms: Diarrhea

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
SDChills ✓ ✓ ✓
SDDiarrhoea ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDInjection site erythema · · ✓
SDInjection site pruritus · · ✓
SDInjection site rash ✓ ✓ ✓
SDLymphadenopathy ✓ ✓ ✓
SDMyalgia ✓ ✓ ✓
SDOropharyngeal pain ✓ ✓ ✓
SDPruritus ✓ ✓ ○
SROCOVID-19 ✓ ✓ ✓
SROLung disorder ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓
SROProductive cough ✓ ✓ ✓
SROPulmonary pain ✓ ✓ ✓
SROSARS-CoV-2 antibody test positive ✓ ✓ ✓

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