58H-24789-81603
3 vaccinations
7 coded responses
17 check-ins
7 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 033 / NH
- Registered
- 2020-12-24
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-24
Registered in v-safe
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2020-12-29
Dose 1 — Moderna
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2021-01-27
Dose 2 — Moderna
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2021-01-28
Survey response — days 1–6 daily, dose 2MedDRA: Vitreous detachment — Feeling: Good · Site: PainFree text: 1week ago I was diagnosed with posterior vitreous detachmentMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-29
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2021-01-30
Survey response — days 1–6 daily, dose 2MedDRA: Arthralgia — Feeling: GoodFree text: Shoulder pain upon waking up that resolved in one hourMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-31
- 2021-02-01
- 2021-02-03
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2021-02-12
Survey response — day 14, dose 2MedDRA: Headache — Feeling: GoodFree text: Have had two headaches over the last few daysMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-19
- 2021-02-24
- 2021-03-05
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2021-03-10
Survey response — day 42, dose 2MedDRA: Headache, Rhinorrhoea — Feeling: GoodFree text: Headache a few days and a little runny nose. Could be spring allergy symptoms.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-28
Survey response — 3 months, dose 2MedDRA: Cough, Rhinorrhoea — Feeling: GoodFree text: Allergy season so runny nose and mild cough. My usual spring tree allergies.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-30
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2021-10-27
Dose 3 — Moderna
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2022-01-27
Survey response — 12 months, dose 2MedDRA: Bloody discharge, Breast discharge, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Bloody discharge from right nipple. Has been evaluated and no medical concernsMedDRA releases: 2024-11 · check-in free text available
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2022-01-27
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-01-29
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2022-02-01
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2022-04-27
Survey response — 6 months, dose 3MedDRA: Breast cancer, Breast conserving surgery — Feeling: Good · 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: Symptoms: Diagnosed with breast cancer · Healthcare visit (other): Partial mastectomyMedDRA releases: 2024-11 · check-in free text available
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2022-04-27
Report sent to call center — 6 months, dose 3Be 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)
-
2022-04-28
Call successfulNot applicable - Accidental Reporting
- 2022-10-27
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-29 | Moderna | |
| 2 | 2021-01-27 | Moderna | |
| 3 | 2021-10-27 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): 1week ago I was diagnosed with posterior vitreous detachment
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Shoulder pain upon waking up that resolved in one hour
Release 4 — day 14, dose 2
Symptoms: Have had two headaches over the last few days
Release 5 — day 42, dose 2
Symptoms: Headache a few days and a little runny nose. Could be spring allergy symptoms.
Release 8 — 3 months, dose 2
Symptoms: Allergy season so runny nose and mild cough. My usual spring tree allergies.
Release 11 — 12 months, dose 2
Symptoms: Bloody discharge from right nipple. Has been evaluated and no medical concerns
Release 11 — 6 months, dose 3
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 |
|---|---|---|---|---|
| HCVO | Breast conserving surgery | · | · | ✓ |
| SD | Bloody discharge | · | · | ✓ |
| SD | Breast cancer | · | · | ✓ |
| SD | Breast discharge | · | · | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Rhinorrhoea | ✓ | ✓ | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Vitreous detachment | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release