5NB-20030-94160
4 vaccinations
4 coded responses
36 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 052 / VT
- Registered
- 2021-03-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-04
Dose 1 — Moderna
-
2021-03-05
Registered in v-safe
-
2021-03-05
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Chills, DiarrheaAdult check-in
- 2021-03-07
- 2021-03-10
- 2021-03-11
- 2021-03-25
-
2021-04-01
Dose 2 — Moderna
-
2021-04-01
Health check-in — day 0, dose 2Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-02
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-03
-
2021-04-04
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
-
2021-04-15
Survey response — day 14, dose 2MedDRA: Epistaxis — Feeling: FairFree text: NosebleedsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-24
Survey response — day 21, dose 2MedDRA: Emergency care, Epistaxis, Jaw clicking, Lymphadenopathy, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Nosebleeds (ER had to pack it), swollen glands, and clicking jaw. Probably unrelated to vaccine, but that's for you to decide. I think I was also running a slight fever, but my thermometer battery had run down.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-24
Report sent to call center — day 21, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-01
- 2021-05-06
- 2021-05-13
-
2021-07-01
Survey response — 3 months, dose 2MedDRA: Office visit, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · HospitalizationFree text: Symptoms: Colon spasms, but this is a condition that pops up periodically with me. · Healthcare visit (other): discussed at a prescheduled in-office appointment.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-07-01
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-07
-
2021-10-02
Survey response — 6 months, dose 2MedDRA: Laboratory test abnormal, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Unrelated to COVID, have tested positive on Cologuard test, so may have cancer or precancerous polyps. · Healthcare visit (other): Scheduling colonoscopyMedDRA releases: 2024-11 · check-in free text available
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2021-10-02
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
-
2021-10-07
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2021-11-02
Dose 3 — Moderna
- 2022-04-03
-
2022-05-03
Dose 4 — Moderna
- 2022-05-03
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2022-05-04
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2022-05-05
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness, Abdominal painAdult check-in
- 2022-05-06
- 2022-05-08
- 2022-05-09
- 2022-05-10
- 2022-05-17
- 2022-05-24
- 2022-05-31
- 2022-06-08
- 2022-06-14
- 2022-08-02
- 2022-11-01
- 2023-05-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-04 | Moderna | |
| 2 | 2021-04-01 | Moderna | |
| 3 | 2021-11-02 | Moderna | No |
| 4 | 2022-05-03 | Moderna | No |
Call center
3 call center cases
1 successful · 2 unsuccessful
Free text
Release 7 — day 14, dose 2
Symptoms: Nosebleeds
Release 7 — day 21, dose 2
Symptoms: Nosebleeds (ER had to pack it), swollen glands, and clicking jaw. Probably unrelated to vaccine, but that's for you to decide. I think I was also running a slight fever, but my thermometer battery had run down.
Release 9 — 3 months, dose 2
Symptoms: Colon spasms, but this is a condition that pops up periodically with me.
Healthcare visit (other): discussed at a prescheduled in-office appointment.
Release 9 — 6 months, dose 2
Symptoms: Unrelated to COVID, have tested positive on Cologuard test, so may have cancer or precancerous polyps.
Healthcare visit (other): Scheduling colonoscopy
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 | Office visit | ✓ | ✓ | ✓ |
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Emergency care | ✓ | ✓ | ✓ |
| SD | Epistaxis | ✓ | ✓ | ✓ |
| SD | Jaw clicking | ✓ | ✓ | ✓ |
| SD | Laboratory test abnormal | · | · | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release