55W-52209-46642
1 vaccination
6 coded responses
6 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 615 / IL
- Registered
- 2022-02-27
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2022-02-23
Dose 1 — Moderna
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2022-02-27
Registered in v-safe
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2022-02-27
Survey response — days 1–6 daily, dose 1MedDRA: Respiratory disorder, Syncope — Feeling: Fair · Site: PainFree text: I started to faint and breathing was a little issue after the shot.MedDRA releases: 2024-11 · check-in free text available
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2022-02-28
Survey response — days 1–6 daily, dose 1MedDRA: Nasopharyngitis — Feeling: Fair · Chills, Muscle or body aches, Fatigue or tirednessFree text: Coming down with a coldMedDRA releases: 2024-11 · check-in free text available
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2022-03-01
Survey response — days 1–6 daily, dose 1MedDRA: Cough — Feeling: Fair · Muscle or body aches, Fatigue or tirednessFree text: CoughingMedDRA releases: 2024-11 · check-in free text available
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2022-03-11
Survey response — day 14, dose 1MedDRA: Chills, Dysphonia, Rhinorrhoea, Sinusitis — Feeling: PoorFree text: I believe I have an sinus infection. Chills, runny nose, voice sounds funny and my nose drainage is green.MedDRA releases: 2024-11 · check-in free text available
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2022-03-16
Survey response — day 21, dose 1MedDRA: Nasal discomfort, Self-medication, Sinus congestion — Feeling: FairFree text: Severe sinus congestion in one nostril. Still blowing my nose. If this doesn't get better soon I will see a Doctor. Taking over the counter meds to help with nasal discomfort.MedDRA releases: 2024-11 · check-in free text available
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2022-05-25
Survey response — 3 months, dose 1MedDRA: Cough, Discharge, Headache, Influenza — 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 · Outpatient clinic or urgent care clinic visitFree text: I came down with Influenza A on May 11th. Still have drainage, cough and headache.MedDRA releases: 2024-11 · check-in free text available
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2022-05-25
Report sent to call center — 3 months, dose 1Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-05-26
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 | 2022-02-23 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 11 — days 1–6 daily, dose 1
Systemic reaction (other): I started to faint and breathing was a little issue after the shot.
Systemic reaction (other): Coming down with a cold
Systemic reaction (other): Coughing
Release 11 — day 14, dose 1
Symptoms: I believe I have an sinus infection. Chills, runny nose, voice sounds funny and my nose drainage is green.
Release 11 — day 21, dose 1
Symptoms: Severe sinus congestion in one nostril. Still blowing my nose. If this doesn't get better soon I will see a Doctor. Taking over the counter meds to help with nasal discomfort.
Release 11 — 3 months, dose 1
Symptoms: I came down with Influenza A on May 11th. Still have drainage, cough and headache.
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 | Chills | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Discharge | · | · | ✓ |
| SD | Dysphonia | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Nasal discomfort | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Nasopharyngitis | · | · | ✓ |
| SRO | Respiratory disorder | · | · | ✓ |
| SRO | Syncope | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release