4ZV-32947-59980
3 vaccinations
8 coded responses
43 check-ins
8 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 200 / DC
- Registered
- 2021-03-02
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
REX-11308-95537
Child or adolescent in my care · Female · 2022-07-05
Timeline
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2021-03-02
Registered in v-safe
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2021-03-05
Dose 1 — Moderna
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2021-03-05
Health check-in — day 0, dose 1Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tirednessAdult check-in
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2021-03-06
Survey response — days 1–6 daily, dose 1MedDRA: Glossodynia, Tongue eruption — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activitiesFree text: Tongue rash/sensitivity at tip of tongueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-07
Survey response — days 1–6 daily, dose 1MedDRA: Feeling abnormal — Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Fuzzy headedness (spacy feeling)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-08
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, NauseaAdult check-in
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2021-03-09
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Redness, Itching · NauseaAdult check-in
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2021-03-10
Survey response — days 1–6 daily, dose 1MedDRA: Injection site discolouration, Injection site hypoaesthesia — Feeling: Good · Site: Redness, ItchingFree text: Skin at injection site is dark color (not really red, more tan-brown) and I have some loss of sensation/numbness thereMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-11
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Itching · NoneAdult check-in
- 2021-03-12
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2021-03-19
Survey response — day 14, dose 1MedDRA: Injection site discolouration, Injection site pruritus — Feeling: GoodFree text: Itchy dark patch on my arm (at injection site) that is not improving.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-26
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2021-04-02
Survey response — day 28, dose 1MedDRA: Pregnancy, Skin discolouration — Feeling: GoodFree text: I recently found out that I am pregnant. Separately, I still have a dark patch on my arm from my first covid shot a month ago.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-11
Survey response — day 35, dose 1MedDRA: Fatigue, Nausea, Pregnancy — Feeling: Fair · Be unable to work, Be unable to do your normal daily activitiesFree text: Increased nausea and fatigue associated with week 6 of pregnancyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-16
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2021-04-18
Pregnancy registry surveyPregnant after vaccination · Yes, I would like someone to contact me
- 2021-06-04
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2021-06-05
Dose 2 — Moderna
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2021-06-05
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-06-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
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2021-06-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, NauseaAdult check-in
- 2021-06-08
- 2021-06-09
- 2021-06-10
- 2021-06-11
- 2021-06-12
- 2021-06-21
- 2021-06-26
- 2021-07-03
- 2021-07-10
- 2021-07-17
- 2021-09-04
- 2021-12-04
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2022-01-04
Dose 3 — Moderna
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2022-01-04
Survey response — day 0, dose 3MedDRA: Breast feeding, Breast tenderness — Feeling: Good · Site: Pain, Redness · Headache, Fatigue or tirednessFree text: I am breastfeeding and I feel that my breasts are more tender and perhaps increased milk productionMedDRA releases: 2024-11 · check-in free text available
- 2022-01-05
- 2022-01-06
- 2022-01-07
- 2022-01-09
- 2022-01-10
- 2022-01-11
- 2022-01-18
- 2022-01-25
- 2022-02-01
- 2022-02-08
- 2022-02-15
- 2022-04-05
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2022-07-05
Survey response — 6 months, dose 3MedDRA: Brain fog, COVID-19, Cough, Ear pain, Fatigue, Headache, Muscle twitching, Paraesthesia, Respiratory tract congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Covid infection: itchy throat, congestion, cough, headache, fatigue, brain fog, muscle twitches, body buzzing, earacheMedDRA releases: 2024-11 · check-in free text available
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2022-07-05
Report sent to call center — 6 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-07-06
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-05 | Moderna | |
| 2 | 2021-06-05 | Moderna | |
| 3 | 2022-01-04 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Tongue rash/sensitivity at tip of tongue
Systemic reaction (other): Fuzzy headedness (spacy feeling)
Systemic reaction (other): Skin at injection site is dark color (not really red, more tan-brown) and I have some loss of sensation/numbness there
Release 5 — day 14, dose 1
Symptoms: Itchy dark patch on my arm (at injection site) that is not improving.
Release 6 — day 28, dose 1
Symptoms: I recently found out that I am pregnant. Separately, I still have a dark patch on my arm from my first covid shot a month ago.
Release 7 — day 35, dose 1
Symptoms: Increased nausea and fatigue associated with week 6 of pregnancy
Release 10 — day 0, dose 3
Systemic reaction (other): I am breastfeeding and I feel that my breasts are more tender and perhaps increased milk production
Release 12 — 6 months, dose 3
Symptoms: Covid infection: itchy throat, congestion, cough, headache, fatigue, brain fog, muscle twitches, body buzzing, earache
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 | Brain fog | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Ear pain | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Injection site discolouration | ✓ | ✓ | ✓ |
| SD | Injection site pruritus | ✓ | ✓ | ✓ |
| SD | Muscle twitching | · | · | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Paraesthesia | · | · | ✓ |
| SD | Pregnancy | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Skin discolouration | ✓ | ✓ | ✓ |
| SRO | Breast feeding | · | · | ✓ |
| SRO | Breast tenderness | · | · | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Glossodynia | ✓ | ✓ | ✓ |
| SRO | Injection site discolouration | ✓ | ✓ | ✓ |
| SRO | Injection site hypoaesthesia | ✓ | ✓ | ✓ |
| SRO | Tongue eruption | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release