5N2-19252-80361
5 vaccinations
5 coded responses
40 check-ins
5 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 780 / TX
- Registered
- 2021-02-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-07
Dose 1 — Moderna
-
2021-02-04
Dose 2 — Moderna
-
2021-02-05
Registered in v-safe
-
2021-02-05
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
-
2021-02-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Muscle or body aches, DiarrheaAdult check-in
- 2021-02-07
-
2021-02-08
Survey response — days 1–6 daily, dose 2MedDRA: Adverse reaction, Pre-existing disease — Feeling: Fair · Headache · Be unable to do your normal daily activitiesFree text: I have (b)(6) and wonder whether my intense reaction is due to my t cells reacting to vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-09
-
2021-02-10
Survey response — days 1–6 daily, dose 2MedDRA: Headache, Hypersensitivity — Feeling: Good · HeadacheFree text: I am not certain I can attribute the mild headache during the night to the vaccination. It could easily be from allergiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-11
- 2021-02-18
- 2021-02-25
-
2021-03-04
Survey response — day 28, dose 2MedDRA: Constipation — Feeling: FairFree text: GI distress twice this week. No other symptoms.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-12
- 2021-03-18
- 2021-05-06
- 2021-08-05
-
2021-09-17
Dose 3 — Moderna
- 2021-10-24
- 2021-10-29
-
2021-12-17
Survey response — 3 months, dose 3MedDRA: Pre-existing disease, Respiratory tract congestion, Rhinorrhoea — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Probably seasonal allergies: runny nose, minor chest congestionMedDRA releases: 2024-11 · check-in free text available
-
2021-12-17
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-12-21
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-03-20
-
2022-05-23
Dose 4 — Moderna
- 2022-05-23
-
2022-05-24
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
- 2022-05-26
- 2022-05-27
- 2022-05-28
- 2022-05-29
- 2022-05-30
- 2022-06-06
- 2022-06-13
- 2022-06-20
- 2022-06-27
- 2022-07-04
- 2022-08-22
-
2022-09-21
Dose 5 — Moderna
- 2022-09-27
- 2022-09-28
- 2022-10-05
- 2022-10-12
- 2022-10-19
- 2022-10-26
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2022-11-03
Survey response — day 42, dose 5MedDRA: Conjunctival haemorrhage — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Since receiving 4th COVID vaccine on Sept 24,2022, I've experienced four incidents of subconjunctival hemorrhage In left eye. Don't know if there's an association with the booster.MedDRA releases: 2024-11 · check-in free text available
-
2022-11-03
Report sent to call center — day 42, dose 5Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-11-04
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-12-21
- 2023-03-22
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-07 | Moderna | |
| 2 | 2021-02-04 | Moderna | |
| 3 | 2021-09-17 | Moderna | No |
| 4 | 2022-05-23 | Moderna | No |
| 5 | 2022-09-21 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): I have (b)(6) and wonder whether my intense reaction is due to my t cells reacting to vaccine.
redacted (b)(6)
Systemic reaction (other): I am not certain I can attribute the mild headache during the night to the vaccination. It could easily be from allergies
Release 5 — day 28, dose 2
Symptoms: GI distress twice this week. No other symptoms.
Release 10 — 3 months, dose 3
Symptoms: Probably seasonal allergies: runny nose, minor chest congestion
Release 12 — day 42, dose 5
Symptoms: Since receiving 4th COVID vaccine on Sept 24,2022, I've experienced four incidents of subconjunctival hemorrhage In left eye. Don't know if there's an association with the booster.
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 | Conjunctival haemorrhage | · | · | ✓ |
| SD | Constipation | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Adverse reaction | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Hypersensitivity | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release