567-29671-50438
5 vaccinations
2 coded responses
37 check-ins
2 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 980 / WA
- Registered
- 2021-11-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
LAX-27822-82888
Child or adolescent in my care · Male · 2022-06-28
Timeline
-
2021-04-13
Dose 1 — Moderna
-
2021-05-11
Dose 2 — Moderna
-
2021-11-13
Registered in v-safe
- 2021-11-13
-
2021-11-17
Dose 3 — Moderna
- 2021-11-17
-
2021-11-18
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-11-19
- 2021-11-21
- 2021-11-22
- 2021-11-23
- 2021-11-24
- 2021-12-01
- 2021-12-08
- 2021-12-15
- 2021-12-22
- 2021-12-29
- 2022-02-18
-
2022-07-26
Dose 4 — Moderna
- 2022-07-26
-
2022-07-27
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-07-28
- 2022-08-01
-
2022-08-02
Survey response — day 7, dose 4MedDRA: Oropharyngeal pain — Feeling: Good · HeadacheFree text: Sore throatMedDRA releases: 2024-11 · check-in free text available
-
2022-08-09
Survey response — day 14, dose 4MedDRA: Oropharyngeal pain, Rhinorrhoea — Feeling: Good · Be unable to work or attend schoolFree text: Sore throat, runny noseMedDRA releases: 2024-11 · check-in free text available
- 2022-08-19
- 2022-08-25
- 2022-08-30
- 2022-09-06
- 2022-10-25
-
2022-11-05
Dose 5 — Moderna
-
2022-11-06
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2022-11-07
- 2022-11-08
- 2022-11-09
- 2022-11-10
- 2022-11-11
-
2022-11-12
Health check-in — day 7, dose 5Feeling: Fair · Headache · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
- 2022-11-19
- 2022-11-27
- 2022-12-03
- 2022-12-10
- 2022-12-17
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-13 | Moderna | No |
| 2 | 2021-05-11 | Moderna | No |
| 3 | 2021-11-17 | Moderna | No |
| 4 | 2022-07-26 | Moderna | No |
| 5 | 2022-11-05 | Moderna | No |
Free text
Release 12 — day 7, dose 4
Systemic reaction (other): Sore throat
Release 12 — day 14, dose 4
Symptoms: Sore throat, runny nose
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 | Oropharyngeal pain | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Oropharyngeal pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release