5DJ-56289-74266
3 vaccinations
6 coded responses
25 check-ins
6 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 757 / TX
- Registered
- 2020-12-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-30
Dose 1 — Moderna
-
2020-12-31
Registered in v-safe
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2020-12-31
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tirednessAdult check-in
-
2021-01-01
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tirednessAdult check-in
- 2021-01-02
-
2021-01-03
Survey response — days 1–6 daily, dose 1MedDRA: Pruritus — Feeling: Fair · Fatigue or tirednessFree text: ItchingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-04
- 2021-01-05
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2021-01-07
Health check-in — day 7, dose 1Feeling: Fair · Site: Redness, Itching · Fatigue or tirednessAdult check-in
- 2021-01-20
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2021-01-27
Dose 2 — Moderna
- 2021-01-27
-
2021-01-28
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-29
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-01-30
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tirednessAdult check-in
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2021-01-31
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · Fatigue or tirednessAdult check-in
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2021-02-01
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
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2021-02-03
Survey response — day 7, dose 2MedDRA: Contusion — Feeling: GoodFree text: Big nasty bruiseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-10
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2021-02-17
Survey response — day 21, dose 2MedDRA: Diarrhoea — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Diarrhea-it could be from something I ate though. It seemed to start after I picked up a salad from Piadas, but I cant get it to stop.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-24
- 2021-03-03
- 2021-03-10
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2021-04-28
Survey response — 3 months, dose 2MedDRA: Mouth ulceration — Feeling: GoodFree text: Im having ulcers in my mouth a lot!! Big painful ones.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-28
Survey response — 6 months, dose 2MedDRA: Mouth ulceration, Pre-existing disease — Feeling: GoodFree text: Ulcers in my mouth have been frequent. Had them as a teen but not like this. HELP! I need the LOT# of my second vaccination. Im traveling and have been asked for it. Its not written on my card!!Please contact me with that information.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2022-01-27
Survey response — 12 months, dose 2MedDRA: Office visit, Pneumonia, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Symptoms: Had pneumonia but tested negative for COVID thank goodness. · Healthcare visit (other): Went to my pcp for follow up X-raysMedDRA releases: 2024-11 · check-in free text available
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2022-01-27
Report sent to call center — 12 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
- 2022-01-28
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2022-02-24
Dose 3 — Moderna
- 2022-05-26
- 2023-02-24
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-30 | Moderna | |
| 2 | 2021-01-27 | Moderna | |
| 3 | 2022-02-24 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Itching
Release 3 — day 7, dose 2
Systemic reaction (other): Big nasty bruise
Release 4 — day 21, dose 2
Symptoms: Diarrhea-it could be from something I ate though. It seemed to start after I picked up a salad from Piadas, but I cant get it to stop.
Release 8 — 3 months, dose 2
Symptoms: Im having ulcers in my mouth a lot!! Big painful ones.
Release 9 — 6 months, dose 2
Symptoms: Ulcers in my mouth have been frequent. Had them as a teen but not like this. HELP! I need the LOT# of my second vaccination. Im traveling and have been asked for it. Its not written on my card!!Please contact me with that information.
Release 11 — 12 months, dose 2
Symptoms: Had pneumonia but tested negative for COVID thank goodness.
Healthcare visit (other): Went to my pcp for follow up X-rays
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 | Office visit | · | · | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Mouth ulceration | ✓ | ✓ | ✓ |
| SD | Pneumonia | · | · | ✓ |
| SD | Pre-existing disease | ✓ | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SRO | Contusion | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release