5J3-12814-12687
3 vaccinations
17 coded responses
37 check-ins
17 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 151 / PA
- Registered
- 2021-04-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
EXK-32807-89381
Child or adolescent in my care · Female · 2021-12-02
Timeline
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2021-03-31
Dose 1 — Moderna
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2021-04-01
Registered in v-safe
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2021-04-01
Survey response — days 1–6 daily, dose 1MedDRA: Fatigue — Feeling: Fair · Site: Pain, Swelling · Muscle or body achesFree text: TirednessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-02
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: GoodFree text: Slight soreness at injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-14
- 2021-04-21
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2021-04-28
Dose 2 — Moderna
- 2021-04-28
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2021-04-29
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
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2021-04-30
Survey response — days 1–6 daily, dose 2MedDRA: Constipation — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessFree text: ConstipationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-01
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2021-05-02
Survey response — days 1–6 daily, dose 2MedDRA: Constipation — Feeling: GoodFree text: ConstipationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-03
Survey response — days 1–6 daily, dose 2MedDRA: Constipation — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to workFree text: ConstipatedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-04
Survey response — days 1–6 daily, dose 2MedDRA: Constipation — Feeling: GoodFree text: ConstipationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-05
Survey response — day 7, dose 2MedDRA: Constipation — Feeling: GoodFree text: ConstipationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-12
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2021-05-19
Survey response — day 21, dose 2MedDRA: Oropharyngeal pain — Feeling: FairFree text: Sore throatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-26
- 2021-06-02
- 2021-06-09
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2021-07-30
Survey response — 3 months, dose 2MedDRA: Cough, Respiratory tract congestion — Feeling: GoodFree text: Still have a cough and congestionMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-10-27
Survey response — 6 months, dose 2MedDRA: Chills, Cough, Diarrhoea, Headache, Nasal congestion, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Sore throat, stuff nose, cough, headache, diarrhea, chillsMedDRA releases: 2024-11 · check-in free text available
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2021-12-02
Dose 3 — Moderna
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2021-12-03
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-12-04
Survey response — days 1–6 daily, dose 3MedDRA: Cough, Injection site mass — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tirednessFree text: Still a lump where I got the shot and coughingMedDRA releases: 2024-11 · check-in free text available
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2021-12-05
Survey response — days 1–6 daily, dose 3MedDRA: Injection site mass — Feeling: Fair · Site: Swelling · Headache, Muscle or body aches, Fatigue or tirednessFree text: Still have a lump at location of injectionMedDRA releases: 2024-11 · check-in free text available
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2021-12-06
Survey response — days 1–6 daily, dose 3MedDRA: Injection site mass — Feeling: Fair · Site: Swelling · Muscle or body aches, Fatigue or tirednessFree text: Still have slight lump at injection siteMedDRA releases: 2024-11 · check-in free text available
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2021-12-07
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Swelling · Fatigue or tirednessAdult check-in
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2021-12-08
Survey response — days 1–6 daily, dose 3MedDRA: Rhinorrhoea — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tirednessFree text: Runny noseMedDRA releases: 2024-11 · check-in free text available
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2021-12-09
Survey response — day 7, dose 3MedDRA: Rhinorrhoea — Feeling: Fair · Muscle or body aches, Fatigue or tirednessFree text: Runny noseMedDRA releases: 2024-11 · check-in free text available
- 2021-12-16
- 2021-12-23
- 2021-12-30
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2022-01-06
Survey response — day 35, dose 3MedDRA: Abdominal pain upper, Diarrhoea, Ear pain, Nasal congestion — Feeling: PoorFree text: Ear ache, diarrhea, stomach pain, nasal congestionMedDRA releases: 2024-11 · check-in free text available
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2022-01-13
Survey response — day 42, dose 3MedDRA: Cough, Diarrhoea, Dyspnoea, Fatigue, Headache, Hypogeusia, Migraine, Oropharyngeal pain — Feeling: PoorFree text: Diarrhea, sore throat, trouble catching my breath after coughing, fatigue, having trouble tasting some, headache/migraineMedDRA releases: 2024-11 · check-in free text available
- 2022-03-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-31 | Moderna | |
| 2 | 2021-04-28 | Moderna | |
| 3 | 2021-12-02 | Moderna | No |
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Tiredness
Systemic reaction (other): Slight soreness at injection site
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): Constipation
Systemic reaction (other): Constipation
Systemic reaction (other): Constipated
Systemic reaction (other): Constipation
Release 8 — day 7, dose 2
Systemic reaction (other): Constipation
Release 8 — day 21, dose 2
Symptoms: Sore throat
Release 9 — 3 months, dose 2
Symptoms: Still have a cough and congestion
Release 10 — 6 months, dose 2
Symptoms: Sore throat, stuff nose, cough, headache, diarrhea, chills
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Still a lump where I got the shot and coughing
Systemic reaction (other): Still have a lump at location of injection
Systemic reaction (other): Still have slight lump at injection site
Systemic reaction (other): Runny nose
Release 10 — day 7, dose 3
Systemic reaction (other): Runny nose
Release 10 — day 35, dose 3
Symptoms: Ear ache, diarrhea, stomach pain, nasal congestion
Release 10 — day 42, dose 3
Symptoms: Diarrhea, sore throat, trouble catching my breath after coughing, fatigue, having trouble tasting some, headache/migraine
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 | Abdominal pain upper | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Cough | ✓ | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Ear pain | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Hypogeusia | · | · | ✓ |
| SD | Migraine | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | ✓ | · | ✓ |
| SRO | Constipation | ✓ | ✓ | ✓ |
| SRO | Cough | · | · | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Injection site mass | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release