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5HS-99741-40011

4 vaccinations 7 coded responses 23 check-ins 7 free-text entries 0 call cases
Sex
Female
Age at first dose
56-60
ZIP prefix
960 / CA
Registered
2021-04-06
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-04-06
    Registered in v-safe
  2. 2021-04-06
    Dose 1 — Moderna
  3. 2021-04-06
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-04-07
    Survey response — days 1–6 daily, dose 1
    MedDRA: Headache, Malaise, Self-medication — Feeling: Good · Site: Pain, Redness · Fatigue or tiredness
    Free text: Headache & vague icky feeling YESTERDAY, 4.75 hrs after shot. Took 2 aspirin, it went away.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-04-08
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Swelling · None
    Adult check-in
  6. 2021-04-09
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pruritus — Feeling: Good
    Free text: Slight itchiness YESTERDAY, after vcheck was done
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-04-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-04-12
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-04-15
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-04-27
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-05-05
    Dose 2 — Moderna
  12. 2021-05-05
    Survey response — day 0, dose 2
    MedDRA: Decreased appetite, Discomfort, Insomnia, Malaise, Pyrexia — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Lack of appetite, malaise, kept waking up at night due to discomfort of fever
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-05-06
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Swelling · None
    Adult check-in
  14. 2021-05-08
    Survey response — days 1–6 daily, dose 2
    MedDRA: Lymphadenopathy, Oral pain, Stomatitis — Feeling: Good
    Free text: Moderately swollen lymph node at base of neck on side of injection. Also, mild soreness on roof of mouth has turned into sore. May not be related to
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-05-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-05-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-05-11
    Survey response — days 1–6 daily, dose 2
    MedDRA: Mouth ulceration — Feeling: Good
    Free text: Dime-sized ulcer on roof of mouth healing slowly. Never ever had similar sore, not caused by any known injury.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-05-12
    Survey response — day 7, dose 2
    MedDRA: Stomatitis — Feeling: Good
    Free text: Sore on roof of mouth still not healed
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  19. 2021-05-19
    Survey response — day 14, dose 2
    MedDRA: Ear infection — Feeling: Good
    Free text: Minor ear infection
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-05-26
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-06-04
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-06-09
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-06-16
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-08-04
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-11-03
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-11-29
    Dose 3 — Moderna
    Co-administered: Flu
  27. 2022-09-16
    Dose 4 — Moderna
  28. 2022-10-10
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-04-06Moderna
22021-05-05Moderna
32021-11-29Moderna Flu
42022-09-16Moderna No

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-07

Systemic reaction (other): Headache & vague icky feeling YESTERDAY, 4.75 hrs after shot. Took 2 aspirin, it went away.

2021-04-09

Systemic reaction (other): Slight itchiness YESTERDAY, after vcheck was done

Release 8 — day 0, dose 2

2021-05-05

Systemic reaction (other): Lack of appetite, malaise, kept waking up at night due to discomfort of fever

Release 8 — days 1–6 daily, dose 2

2021-05-08

Systemic reaction (other): Moderately swollen lymph node at base of neck on side of injection. Also, mild soreness on roof of mouth has turned into sore. May not be related to

2021-05-11

Systemic reaction (other): Dime-sized ulcer on roof of mouth healing slowly. Never ever had similar sore, not caused by any known injury.

Release 8 — day 7, dose 2

2021-05-12

Systemic reaction (other): Sore on roof of mouth still not healed

Release 8 — day 14, dose 2

2021-05-19

Symptoms: Minor ear infection

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
SDEar infection ✓ ✓ ✓
SRODecreased appetite ✓ ✓ ✓
SRODiscomfort ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SROInsomnia ✓ ✓ ✓
SROLymphadenopathy ✓ ✓ ✓
SROMalaise ✓ ✓ ✓
SROMouth ulceration ✓ ✓ ✓
SROOral pain ✓ ✓ ✓
SROPruritus ✓ ✓ ✓
SROPyrexia ✓ ✓ ✓
SROSelf-medication ✓ ✓ ✓
SROStomatitis ✓ ✓ ✓

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