57Z-10499-72242
3 vaccinations
5 coded responses
38 check-ins
5 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 983 / WA
- Registered
- 2021-02-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-06
Dose 1 — Moderna
-
2021-02-08
Registered in v-safe
-
2021-02-08
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Itching · Fatigue or tirednessAdult check-in
- 2021-02-09
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2021-02-10
Survey response — days 1–6 daily, dose 1MedDRA: Pre-existing disease, Therapeutic response unexpected — Feeling: Good · Fatigue or tirednessFree text: I have had acid reflux very bad symptoms for several months I took no medications of any kind for 48 hours until I had my vaccine and I have had no acid reflex symptoms since I got the vaccine because I wanted to make sure I didnt have any kind of reaction because of medicine. I havent started taking antacid meds because since I havent had any need to. Maybe just a coincidence.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-11
- 2021-02-12
- 2021-02-13
- 2021-02-20
- 2021-02-27
-
2021-03-06
Dose 2 — Moderna
- 2021-03-06
-
2021-03-07
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-03-08
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Fatigue or tiredness · Be unable to workAdult check-in
- 2021-03-09
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2021-03-10
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tirednessAdult check-in
-
2021-03-11
Survey response — days 1–6 daily, dose 2MedDRA: Back pain — Feeling: Good · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tirednessFree text: Lower back painMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-12
- 2021-03-13
- 2021-03-20
- 2021-03-27
-
2021-04-05
Survey response — day 28, dose 2MedDRA: Dizziness — Feeling: Fair · Be unable to do your normal daily activitiesFree text: DizzyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-10
- 2021-04-17
- 2021-06-05
- 2021-09-06
-
2021-10-30
Dose 3 — Moderna
- 2021-10-30
-
2021-10-31
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-11-01
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Fatigue or tirednessAdult check-in
-
2021-11-03
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-11-04
- 2021-11-05
- 2021-11-06
- 2021-11-13
- 2021-11-20
- 2021-11-27
- 2021-12-04
- 2021-12-11
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2022-01-29
Survey response — 3 months, dose 3MedDRA: Fatigue, Headache, Rhinorrhoea, Throat irritation — Feeling: Good · Be unable to do your normal daily activitiesFree text: Runny nose, scratchy throat, headache, fatigueMedDRA releases: 2024-11 · check-in free text available
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2022-04-30
Survey response — 6 months, dose 3MedDRA: Exposure to SARS-CoV-2, Influenza, Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Cold/flu symptoms - other family members had Covid but my test was negative that was in January.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-30
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-06 | Moderna | |
| 2 | 2021-03-06 | Moderna | |
| 3 | 2021-10-30 | Moderna | No |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): I have had acid reflux very bad symptoms for several months I took no medications of any kind for 48 hours until I had my vaccine and I have had no acid reflex symptoms since I got the vaccine because I wanted to make sure I didnt have any kind of reaction because of medicine. I havent started taking antacid meds because since I havent had any need to. Maybe just a coincidence.
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Lower back pain
Release 7 — day 28, dose 2
Symptoms: Dizzy
Release 11 — 3 months, dose 3
Symptoms: Runny nose, scratchy throat, headache, fatigue
Release 11 — 6 months, dose 3
Symptoms: Cold/flu symptoms - other family members had Covid but my test was negative that was in January.
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 | Dizziness | ✓ | ✓ | ✓ |
| SD | Exposure to SARS-CoV-2 | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Throat irritation | · | · | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Therapeutic response unexpected | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release