527-11173-64613
4 vaccinations
5 coded responses
50 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 236 / VA
- 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
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-11
- 2021-02-18
- 2021-02-25
- 2021-03-04
-
2021-03-09
Dose 2 — Moderna
-
2021-03-11
Survey response — days 1–6 daily, dose 2MedDRA: Chills, Fatigue, Myalgia, Nausea, Pain — Feeling: Good · Site: PainFree text: 2 days ago had pain, chills, nausea, fatigue, muscle aches, some also yesterdayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-12
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-03-13
- 2021-03-14
-
2021-03-15
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fatigue or tiredness, NauseaAdult check-in
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-04-06
- 2021-04-13
- 2021-04-22
- 2021-06-08
-
2021-09-09
Survey response — 6 months, dose 2MedDRA: Anosmia, Decreased appetite, Dyspnoea, Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activitiesFree text: COVID like symptoms in July that lasted about 2 weeks for worst symptoms and 3-4 weeks total. I had cold symptoms, loss of smell, trouble breathing that I nearly went to the hospital to have treated and loss of appetite. COVID rapid test negativeMedDRA releases: 2024-11 · check-in free text available
-
2021-11-19
Dose 3 — Moderna
-
2021-11-20
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness, NauseaAdult check-in
- 2021-11-21
-
2021-11-22
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Redness · Fatigue or tiredness, NauseaAdult check-in
- 2021-11-23
- 2021-11-24
- 2021-11-25
- 2021-11-26
- 2021-12-03
-
2021-12-10
Survey response — day 21, dose 3MedDRA: Office visit, Rash, Rash pruritic, Urticaria — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: A pruritic rash with hives and seemingly random erruptions on body that nearly always start at the scalp, neck or palms of the hands. Seems to reposnd to prednisone so far. Doctor is not sure of the cause. Started 12/2/21MedDRA releases: 2024-11 · check-in free text available
-
2021-12-10
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)
- 2021-12-13
- 2021-12-17
- 2021-12-25
- 2021-12-31
- 2022-02-18
- 2022-05-20
-
2022-09-15
Dose 4 — ModernaCo-administered: Flu
-
2022-09-17
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Redness · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-09-19
- 2022-09-20
- 2022-09-22
- 2022-09-29
-
2022-10-06
Survey response — day 21, dose 4MedDRA: Cough, Nasal congestion, Nasopharyngitis, Oropharyngeal pain, Sneezing — Feeling: FairFree text: Cold symptoms- stuffy nose, sore throat, mild sneezing and coughingMedDRA releases: 2024-11 · check-in free text available
- 2022-10-15
- 2022-10-22
- 2022-10-27
- 2022-12-17
-
2023-03-16
Survey response — 6 months, dose 4MedDRA: Food poisoning, Influenza — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-28 | Moderna | |
| 2 | 2021-03-09 | Moderna | |
| 3 | 2021-11-19 | Moderna | No |
| 4 | 2022-09-15 | Moderna | Flu |
Call center
1 call center case
1 unsuccessful
Free text
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): 2 days ago had pain, chills, nausea, fatigue, muscle aches, some also yesterday
Release 9 — 6 months, dose 2
Symptoms: COVID like symptoms in July that lasted about 2 weeks for worst symptoms and 3-4 weeks total. I had cold symptoms, loss of smell, trouble breathing that I nearly went to the hospital to have treated and loss of appetite. COVID rapid test negative
Release 10 — day 21, dose 3
Symptoms: A pruritic rash with hives and seemingly random erruptions on body that nearly always start at the scalp, neck or palms of the hands. Seems to reposnd to prednisone so far. Doctor is not sure of the cause. Started 12/2/21
Release 12 — day 21, dose 4
Symptoms: Cold symptoms- stuffy nose, sore throat, mild sneezing and coughing
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 | Anosmia | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Decreased appetite | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Food poisoning | · | · | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Rash pruritic | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sneezing | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release