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5EG-91769-46211

2 vaccinations 4 coded responses 20 check-ins 4 free-text entries 0 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
947 / CA
Registered
2021-01-17
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-16
    Dose 1 — Moderna
  2. 2021-01-17
    Registered in v-safe
  3. 2021-01-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  4. 2021-01-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Headache
    Adult check-in
  5. 2021-01-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  6. 2021-01-21
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  7. 2021-01-22
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  8. 2021-01-23
    Health check-in — day 7, dose 1
    Feeling: Good · Site: Itching · None
    Adult check-in
  9. 2021-01-31
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-02-06
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-02-13
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-02-15
    Dose 2 — Moderna
  13. 2021-02-20
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Itching · Headache, Muscle or body aches
    Adult check-in
  14. 2021-02-21
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site erythema, Injection site pruritus, Oral herpes — Feeling: Good · Site: Redness, Itching · Fever
    Free text: the ladt 2-3 days i am experiencing a few "cold sore" breakouts, one in lower lip and another in my private, "saddle-sore" area. The latter could be from my bicycle shorts, but that doesn't explain the one on lip. the point is they are both in thin-skin, sensitive-skin membrane areas. And they councide with a bit of itching, redness near the injection site. i'll take a Benedryl tonight at bedtime, hope that knocks it all down.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-02-23
    Health check-in — day 7, dose 2
    Feeling: Good · Site: Pain, Itching · Headache, Muscle or body aches
    Adult check-in
  16. 2021-03-01
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-03-08
    Survey response — day 21, dose 2
    MedDRA: Seasonal allergy, Sinusitis — Feeling: Poor
    Free text: Sinus infection, likely cuz allergy season
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-03-15
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-03-22
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-03-31
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-05-18
    Survey response — 3 months, dose 2
    MedDRA: Arthralgia, Back pain, Medial tibial stress syndrome, Pain in extremity, Sciatica — Feeling: Good · Be unable to do your normal daily activities
    Free text: Severe sciatica on right side manifesting in acute pain in knee, front shin/calf muscles (medial and lateral), thigh, hip and lower back. At first thought blood clot. Pain now relieving (can now stand, walk and lie flat): Rest, ice, self-massage.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-08-16
    Survey response — 6 months, dose 2
    MedDRA: Dry throat, Nasopharyngitis — Feeling: Good
    Free text: After a crowded open air concert on August 1st, mild dry throat and minor sinus cold symtoms which resolved completely in about 6 days.
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  23. 2022-02-15
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-16Moderna
22021-02-15Moderna

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-21

Systemic reaction (other): the ladt 2-3 days i am experiencing a few "cold sore" breakouts, one in lower lip and another in my private, "saddle-sore" area. The latter could be from my bicycle shorts, but that doesn't explain the one on lip. the point is they are both in thin-skin, sensitive-skin membrane areas. And they councide with a bit of itching, redness near the injection site. i'll take a Benedryl tonight at bedtime, hope that knocks it all down.

Release 5 — day 21, dose 2

2021-03-08

Symptoms: Sinus infection, likely cuz allergy season

Release 8 — 3 months, dose 2

2021-05-18

Symptoms: Severe sciatica on right side manifesting in acute pain in knee, front shin/calf muscles (medial and lateral), thigh, hip and lower back. At first thought blood clot. Pain now relieving (can now stand, walk and lie flat): Rest, ice, self-massage.

Release 9 — 6 months, dose 2

2021-08-16

Symptoms: After a crowded open air concert on August 1st, mild dry throat and minor sinus cold symtoms which resolved completely in about 6 days.

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
SDArthralgia ✓ ✓ ✓
SDBack pain ✓ ✓ ✓
SDDry throat ✓ · ✓
SDMedial tibial stress syndrome ✓ ✓ ✓
SDNasopharyngitis ✓ · ✓
SDPain in extremity ✓ ✓ ✓
SDSciatica ✓ ✓ ✓
SDSeasonal allergy ✓ ✓ ✓
SDSinusitis ✓ ✓ ✓
SROInjection site erythema ✓ ✓ ✓
SROInjection site pruritus ✓ ✓ ✓
SROOral herpes ✓ ✓ ✓

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