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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

  1. 2020-12-24
    Registered in v-safe
  2. 2020-12-29
    Dose 1 — Moderna
  3. 2021-01-27
    Dose 2 — Moderna
  4. 2021-01-28
    Survey response — days 1–6 daily, dose 2
    MedDRA: Vitreous detachment — Feeling: Good · Site: Pain
    Free text: 1week ago I was diagnosed with posterior vitreous detachment
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-01-29
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Headache
    Adult check-in
  6. 2021-01-30
    Survey response — days 1–6 daily, dose 2
    MedDRA: Arthralgia — Feeling: Good
    Free text: Shoulder pain upon waking up that resolved in one hour
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-01-31
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  8. 2021-02-01
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  9. 2021-02-03
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  10. 2021-02-12
    Survey response — day 14, dose 2
    MedDRA: Headache — Feeling: Good
    Free text: Have had two headaches over the last few days
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-02-19
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-02-24
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-03-05
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-03-10
    Survey response — day 42, dose 2
    MedDRA: Headache, Rhinorrhoea — Feeling: Good
    Free 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
  15. 2021-04-28
    Survey response — 3 months, dose 2
    MedDRA: Cough, Rhinorrhoea — Feeling: Good
    Free 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
  16. 2021-07-30
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-10-27
    Dose 3 — Moderna
  18. 2022-01-27
    Survey response — 12 months, dose 2
    MedDRA: Bloody discharge, Breast discharge, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Bloody discharge from right nipple. Has been evaluated and no medical concerns
    MedDRA releases: 2024-11 · check-in free text available
  19. 2022-01-27
    Report sent to call center — 12 months, dose 2
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  20. 2022-01-29
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  21. 2022-02-01
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  22. 2022-04-27
    Survey response — 6 months, dose 3
    MedDRA: 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 visit
    Free text: Symptoms: Diagnosed with breast cancer · Healthcare visit (other): Partial mastectomy
    MedDRA releases: 2024-11 · check-in free text available
  23. 2022-04-27
    Report sent to call center — 6 months, dose 3
    Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  24. 2022-04-28
    Call successful
    Not applicable - Accidental Reporting
  25. 2022-10-27
    Health check-in — 12 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12020-12-29Moderna
22021-01-27Moderna
32021-10-27Moderna No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 2

2021-01-28

Systemic reaction (other): 1week ago I was diagnosed with posterior vitreous detachment

Release 3 — days 1–6 daily, dose 2

2021-01-30

Systemic reaction (other): Shoulder pain upon waking up that resolved in one hour

Release 4 — day 14, dose 2

2021-02-12

Symptoms: Have had two headaches over the last few days

Release 5 — day 42, dose 2

2021-03-10

Symptoms: Headache a few days and a little runny nose. Could be spring allergy symptoms.

Release 8 — 3 months, dose 2

2021-04-28

Symptoms: Allergy season so runny nose and mild cough. My usual spring tree allergies.

Release 11 — 12 months, dose 2

2022-01-27

Symptoms: Bloody discharge from right nipple. Has been evaluated and no medical concerns

Release 11 — 6 months, dose 3

2022-04-27

Symptoms: Diagnosed with breast cancer
Healthcare visit (other): Partial mastectomy

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
HCVOBreast conserving surgery · · ✓
SDBloody discharge · · ✓
SDBreast cancer · · ✓
SDBreast discharge · · ✓
SDCough ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDOffice visit · · ✓
SDRhinorrhoea ✓ ✓ ✓
SROArthralgia ✓ ✓ ✓
SROVitreous detachment ✓ ✓ ✓

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