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57V-11715-25204

2 vaccinations 4 coded responses 25 check-ins 4 free-text entries 2 call cases
Sex
Female
Age at first dose
61-65
ZIP prefix
592 / MT
Registered
2021-02-05
Relationship
Self
Race
American Indian or Alaska Native
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-04
    Dose 1 — Moderna
  2. 2021-02-05
    Registered in v-safe
  3. 2021-02-05
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · None
    Adult check-in
  4. 2021-02-06
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Fatigue or tiredness
    Adult check-in
  5. 2021-02-07
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  6. 2021-02-08
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Itching · Abdominal pain
    Adult check-in
  7. 2021-02-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Itching · None
    Adult check-in
  8. 2021-02-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-02-11
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-02-18
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-02-25
    Survey response — day 21, dose 1
    MedDRA: Office visit, Tympanic membrane perforation — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: I have perforated ear drums. I was given amoxicillin 3 xs a day for 10 days. · Healthcare visit (other): Hpdp nurse practitioner @ the school where I work.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-02-25
    Report sent to call center — day 21, dose 1
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  13. 2021-03-04
    Dose 2 — Moderna
  14. 2021-03-04
    Health check-in — day 0, dose 2
    Feeling: Fair · Site: Pain · Fatigue or tiredness
    Adult check-in
  15. 2021-03-05
    Survey response — days 1–6 daily, dose 2
    MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain · Fatigue or tiredness
    Free text: Woke up with a little sore throat but Im better now.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-03-06
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-03-07
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-03-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-03-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-03-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  21. 2021-03-11
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  22. 2021-03-18
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-03-25
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-04-01
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-04-08
    Survey response — day 35, dose 2
    MedDRA: Abdominal pain upper, Arthralgia, Chills, Diarrhoea, Night sweats, Tension headache — Feeling: Fair · Be unable to work or attend school
    Free text: Stomach pain and cramping had diarrhea,chills tension headache, joints hurt. This all started on Monday 4/5/21 the night before I woke up drenched in sweat.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  26. 2021-04-15
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in
  27. 2021-06-05
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-09-02
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  29. 2021-12-21
  30. 2021-12-27
  31. 2022-03-06
    Survey response — 12 months, dose 2
    MedDRA: Arthralgia, Cough, Headache, Office visit, Oropharyngeal pain — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Symptoms: Achy joints, headache, sore throat, dry cough · Healthcare visit (other): Hpdp nurse practitioner
    MedDRA releases: 2024-11 · check-in free text available
  32. 2022-03-06
    Report sent to call center — 12 months, dose 2
    Be unable to work or attend school · Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  33. 2022-03-09

Vaccinations

DoseDateManufacturerCo-administered
12021-02-04Moderna
22021-03-04Moderna

Call center

2 call center cases

2 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 4 — day 21, dose 1

2021-02-25

Symptoms: I have perforated ear drums. I was given amoxicillin 3 xs a day for 10 days.
Healthcare visit (other): Hpdp nurse practitioner @ the school where I work.

Release 5 — days 1–6 daily, dose 2

2021-03-05

Systemic reaction (other): Woke up with a little sore throat but Im better now.

Release 7 — day 35, dose 2

2021-04-08

Symptoms: Stomach pain and cramping had diarrhea,chills tension headache, joints hurt. This all started on Monday 4/5/21 the night before I woke up drenched in sweat.

Release 11 — 12 months, dose 2

2022-03-06

Symptoms: Achy joints, headache, sore throat, dry cough
Healthcare visit (other): Hpdp nurse practitioner

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

FieldPreferred term2021-092023-042024-11
HCVOOffice visit ✓ ✓ ✓
SDAbdominal pain upper ✓ ✓ ✓
SDArthralgia ✓ ✓ ✓
SDChills ✓ ✓ ✓
SDCough · · ✓
SDDiarrhoea ✓ ✓ ✓
SDHeadache · · ✓
SDNight sweats ✓ ✓ ✓
SDOropharyngeal pain · · ✓
SDTension headache ✓ ✓ ✓
SDTympanic membrane perforation ✓ ✓ ✓
SROOropharyngeal pain ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release