5HZ-16668-90263
4 vaccinations
5 coded responses
55 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 105 / NY
- Registered
- 2021-01-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-21
Registered in v-safe
-
2021-01-21
Dose 1 — Moderna
-
2021-01-22
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fever · Fatigue or tirednessAdult check-in
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-02-04
- 2021-02-11
- 2021-02-18
-
2021-02-25
Dose 2 — Moderna
- 2021-02-25
-
2021-02-26
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-27
- 2021-02-28
- 2021-03-01
- 2021-03-02
-
2021-03-03
Survey response — days 1–6 daily, dose 2MedDRA: Musculoskeletal stiffness — Feeling: Good · Muscle or body achesFree text: Little stiffness in shoulder area of shot. No real pain though.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
- 2021-03-11
- 2021-03-20
- 2021-03-25
- 2021-04-03
- 2021-04-08
- 2021-05-27
- 2021-08-26
-
2021-11-01
Dose 3 — Moderna
-
2021-11-01
Health check-in — day 0, dose 3Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body achesAdult check-in
-
2021-11-02
Survey response — days 1–6 daily, dose 3MedDRA: Chest discomfort, Cough, Nasal congestion, Upper-airway cough syndrome — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Nasal congestion, Post nasal drip n slight cough n chest tightness,MedDRA releases: 2024-11 · check-in free text available
-
2021-11-03
Survey response — days 1–6 daily, dose 3MedDRA: Chest discomfort, Cough — Feeling: Good · Site: PainFree text: Tight chest with occasional dry coughMedDRA releases: 2024-11 · check-in free text available
-
2021-11-04
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-11-06
- 2021-11-07
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-07
- 2021-12-13
- 2022-01-31
- 2022-05-02
-
2022-06-13
Dose 4 — Moderna
- 2022-06-13
-
2022-06-14
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Itching · Headache, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2022-06-15
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Headache, Abdominal painAdult check-in
- 2022-06-16
- 2022-06-17
- 2022-06-18
- 2022-06-19
- 2022-06-20
- 2022-06-27
- 2022-07-04
-
2022-07-13
Survey response — day 28, dose 4MedDRA: Cough, Headache, Nasal congestion, Oropharyngeal pain, Pharyngitis, Rhinorrhoea, SARS-CoV-2 test positive, Unevaluable event — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Tested positive for Covid today. I have Headache, sore throat, nasal congestion, nasal drip, slight cough. It feels like pharyngitis · Healthcare visit (other): Called doctor's office. My doctor away. Nurse schedule virtual visit with another doctor for tomorrowMedDRA releases: 2024-11 · check-in free text available
-
2022-07-13
Report sent to call center — day 28, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-07-14
-
2022-07-14
Callback requested for04:30PM ET
-
2022-07-14
Call successfulDoes not wish to fill out VAERS report
-
2022-07-18
Survey response — day 35, dose 4MedDRA: COVID-19, Diarrhoea, Emergency care, Headache, Malaise, Sinus congestion, Upper-airway cough syndrome — Feeling: Poor · Be unable to work or attend schoolFree text: Have COVID. Got monoclonal antibodies infusion at ER. Feeling better but still feel crummysinus congestion, post nasal drip, headache n diarrheaMedDRA releases: 2024-11 · check-in free text available
- 2022-07-25
- 2022-09-12
- 2022-12-12
- 2023-06-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-21 | Moderna | |
| 2 | 2021-02-25 | Moderna | |
| 3 | 2021-11-01 | Moderna | No |
| 4 | 2022-06-13 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Little stiffness in shoulder area of shot. No real pain though.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Nasal congestion, Post nasal drip n slight cough n chest tightness,
Systemic reaction (other): Tight chest with occasional dry cough
Release 12 — day 28, dose 4
Symptoms: Tested positive for Covid today. I have Headache, sore throat, nasal congestion, nasal drip, slight cough. It feels like pharyngitis
Healthcare visit (other): Called doctor's office. My doctor away. Nurse schedule virtual visit with another doctor for tomorrow
Release 12 — day 35, dose 4
Symptoms: Have COVID. Got monoclonal antibodies infusion at ER. Feeling better but still feel crummysinus congestion, post nasal drip, headache n diarrhea
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 | Unevaluable event | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Emergency care | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pharyngitis | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SD | Upper-airway cough syndrome | · | · | ✓ |
| SRO | Chest discomfort | · | · | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Musculoskeletal stiffness | ✓ | ✓ | ✓ |
| SRO | Nasal congestion | · | · | ✓ |
| SRO | Upper-airway cough syndrome | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release