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
-
2021-04-06
Registered in v-safe
-
2021-04-06
Dose 1 — Moderna
- 2021-04-06
-
2021-04-07
Survey response — days 1–6 daily, dose 1MedDRA: Headache, Malaise, Self-medication — Feeling: Good · Site: Pain, Redness · Fatigue or tirednessFree 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
- 2021-04-08
-
2021-04-09
Survey response — days 1–6 daily, dose 1MedDRA: Pruritus — Feeling: GoodFree text: Slight itchiness YESTERDAY, after vcheck was doneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-10
- 2021-04-12
- 2021-04-15
- 2021-04-27
-
2021-05-05
Dose 2 — Moderna
-
2021-05-05
Survey response — day 0, dose 2MedDRA: 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 activitiesFree text: Lack of appetite, malaise, kept waking up at night due to discomfort of feverMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-06
-
2021-05-08
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy, Oral pain, Stomatitis — Feeling: GoodFree 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 toMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-09
- 2021-05-10
-
2021-05-11
Survey response — days 1–6 daily, dose 2MedDRA: Mouth ulceration — Feeling: GoodFree 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
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2021-05-12
Survey response — day 7, dose 2MedDRA: Stomatitis — Feeling: GoodFree text: Sore on roof of mouth still not healedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-19
Survey response — day 14, dose 2MedDRA: Ear infection — Feeling: GoodFree text: Minor ear infectionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-26
- 2021-06-04
- 2021-06-09
- 2021-06-16
- 2021-08-04
- 2021-11-03
-
2021-11-29
Dose 3 — ModernaCo-administered: Flu
-
2022-09-16
Dose 4 — Moderna
- 2022-10-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-06 | Moderna | |
| 2 | 2021-05-05 | Moderna | |
| 3 | 2021-11-29 | Moderna | Flu |
| 4 | 2022-09-16 | Moderna | No |
Free text
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): Headache & vague icky feeling YESTERDAY, 4.75 hrs after shot. Took 2 aspirin, it went away.
Systemic reaction (other): Slight itchiness YESTERDAY, after vcheck was done
Release 8 — day 0, dose 2
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
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
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
Systemic reaction (other): Sore on roof of mouth still not healed
Release 8 — day 14, dose 2
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Ear infection | ✓ | ✓ | ✓ |
| SRO | Decreased appetite | ✓ | ✓ | ✓ |
| SRO | Discomfort | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Insomnia | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
| SRO | Malaise | ✓ | ✓ | ✓ |
| SRO | Mouth ulceration | ✓ | ✓ | ✓ |
| SRO | Oral pain | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
| SRO | Stomatitis | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release