5JA-64109-70084
5 vaccinations
4 coded responses
59 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 972 / OR
- Registered
- 2021-03-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-08
Registered in v-safe
-
2021-03-08
Dose 1 — Moderna
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-12
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-22
- 2021-03-29
-
2021-04-05
Dose 2 — Moderna
- 2021-04-05
-
2021-04-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-07
- 2021-04-08
- 2021-04-09
-
2021-04-10
Survey response — days 1–6 daily, dose 2MedDRA: Injection site erythema — Feeling: Good · Site: RednessFree text: Redness is on arm below injection site and was there yesterday, too.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-11
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · NoneAdult check-in
- 2021-04-12
- 2021-04-19
- 2021-04-26
- 2021-05-03
- 2021-05-10
- 2021-05-17
- 2021-07-05
- 2021-10-04
-
2021-10-25
Dose 3 — Moderna
-
2021-10-26
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
-
2021-11-08
Survey response — day 14, dose 3MedDRA: Balance disorder, Oscillopsia — Feeling: GoodFree text: Occasional problems with balance and sensation of objects moving back and forth quickly (not room spinning). Seems associated with head movement, especially in bed and on rising from bed. Improves throughout the day each day. Started November 5.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2022-01-24
-
2022-04-18
Dose 4 — Pfizer-BioNTech
- 2022-04-18
-
2022-04-19
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
-
2022-04-20
Survey response — days 1–6 daily, dose 4MedDRA: Body temperature increased, Nasal congestion — Feeling: Good · Site: PainFree text: After yesterday's report I had a slightly elevated temperature and nasal congestion. Both were gone this morning.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-21
- 2022-04-22
- 2022-04-23
- 2022-04-24
- 2022-04-25
- 2022-05-02
-
2022-05-09
Survey response — day 21, dose 4MedDRA: Abdominal discomfort, Diarrhoea, SARS-CoV-2 test negative, Vomiting — Feeling: Good · Be unable to do your normal daily activitiesFree text: Gastrointestinal discomfort May 4 to May 8, including 2 bouts of diarrhea and one incident of vomiting. (Home Covid test was negative.)MedDRA releases: 2024-11 · check-in free text available
- 2022-05-16
- 2022-05-23
- 2022-05-30
- 2022-07-18
-
2022-09-12
Dose 5 — Moderna
- 2022-10-01
- 2022-10-03
- 2022-10-10
- 2022-10-17
- 2022-10-24
- 2022-12-12
- 2023-03-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-08 | Moderna | |
| 2 | 2021-04-05 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-04-18 | Pfizer-BioNTech | No |
| 5 | 2022-09-12 | Moderna | No |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Redness is on arm below injection site and was there yesterday, too.
Release 10 — day 14, dose 3
Symptoms: Occasional problems with balance and sensation of objects moving back and forth quickly (not room spinning). Seems associated with head movement, especially in bed and on rising from bed. Improves throughout the day each day. Started November 5. cut off by CDC
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): After yesterday's report I had a slightly elevated temperature and nasal congestion. Both were gone this morning.
Release 11 — day 21, dose 4
Symptoms: Gastrointestinal discomfort May 4 to May 8, including 2 bouts of diarrhea and one incident of vomiting. (Home Covid test was negative.)
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 discomfort | · | · | ✓ |
| SD | Balance disorder | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Oscillopsia | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
| SRO | Body temperature increased | · | · | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Nasal congestion | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release