567-28430-28587
2 vaccinations
5 coded responses
22 check-ins
5 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 959 / CA
- Registered
- 2021-02-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-02-06
Registered in v-safe
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2021-02-06
Dose 1 — Moderna
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2021-02-08
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Chills, Joint pains · Be unable to workAdult check-in
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2021-02-09
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Abdominal painAdult check-in
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2021-02-10
Survey response — days 1–6 daily, dose 1MedDRA: Feeling abnormal, Insomnia — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessFree text: a little brain fog, trouble sleeping last nightMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-11
Survey response — days 1–6 daily, dose 1MedDRA: Tinnitus — Feeling: Fair · Site: Pain · Chills, Joint pains, Abdominal painFree text: I forgot to mention at the beginning I have ringing in my ears. After the vaccine the ringing has become louder. Just a FYI.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-12
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
- 2021-02-13
- 2021-02-20
- 2021-02-28
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2021-03-03
Dose 2 — Moderna
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2021-03-03
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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2021-03-04
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
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2021-03-05
Survey response — days 1–6 daily, dose 2MedDRA: Body temperature increased, Erythema, Injection site pain, Injection site swelling — Feeling: Fair · Site: Redness · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to workFree text: FOGGY FORGOT TO MENTION: Had vaccine on Wednesday 3/3/21, Had 2 temperatures (1) 3/4/21 of 103.0 at 3:30 am (2) 3/4/21 of 102.3 at 3:45 pm. Also had swelling and pain in the injection site, took shower today and is still red.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-06
Survey response — days 1–6 daily, dose 2MedDRA: Bowel movement irregularity — Feeling: Fair · Site: Pain, Redness · Headache, Joint pains, Muscle or body aches, Abdominal pain · Be unable to do your normal daily activitiesFree text: Having a hard time doing a bowel movmentMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Redness · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
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2021-03-09
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-03-10
Health check-in — day 7, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-03-20
- 2021-03-25
- 2021-04-07
- 2021-04-14
- 2021-06-02
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2021-09-01
Survey response — 6 months, dose 2MedDRA: Memory impairment — Feeling: GoodFree text: Seem to be a little more forgetful.MedDRA releases: 2021-09,2024-11 · check-in free text available
- 2022-03-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-06 | Moderna | |
| 2 | 2021-03-03 | Moderna |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): a little brain fog, trouble sleeping last night
Systemic reaction (other): I forgot to mention at the beginning I have ringing in my ears. After the vaccine the ringing has become louder. Just a FYI.
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): FOGGY FORGOT TO MENTION: Had vaccine on Wednesday 3/3/21, Had 2 temperatures (1) 3/4/21 of 103.0 at 3:30 am (2) 3/4/21 of 102.3 at 3:45 pm. Also had swelling and pain in the injection site, took shower today and is still red.
Systemic reaction (other): Having a hard time doing a bowel movment
Release 9 — 6 months, dose 2
Symptoms: Seem to be a little more forgetful.
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 | Memory impairment | ✓ | · | ✓ |
| SRO | Body temperature increased | ✓ | ✓ | ✓ |
| SRO | Bowel movement irregularity | ✓ | ✓ | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site swelling | ✓ | ✓ | ✓ |
| SRO | Insomnia | ✓ | ✓ | ✓ |
| SRO | Tinnitus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release