5QN-12173-41327
4 vaccinations
4 coded responses
48 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 286 / NC
- Registered
- 2021-01-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-23
Registered in v-safe
-
2021-01-23
Dose 1 — Moderna
- 2021-01-23
-
2021-01-25
Survey response — days 1–6 daily, dose 1MedDRA: Injection site bruising — Feeling: GoodFree text: Only a little bruising at the injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-02-06
- 2021-02-13
-
2021-02-20
Dose 2 — Moderna
- 2021-02-20
-
2021-02-21
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tiredness, DiarrheaAdult check-in
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-02-25
- 2021-02-26
- 2021-02-27
- 2021-03-06
- 2021-03-13
- 2021-03-21
- 2021-03-27
- 2021-04-05
-
2021-05-22
Survey response — 3 months, dose 2MedDRA: Eyelid pain, Office visit, Pre-existing disease, Psoriasis — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Psoriasis at the base of my hairline and on my left eyelid. Second time for psoriasis at the base of my hairline since completing my vaccination. I have never had psoriasis anywhere before. May or may not be related to vaccine. · Healthcare visit (other): My doctor prescribed a cream.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-22
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-21
-
2021-10-27
Dose 3 — Moderna
- 2021-10-27
-
2021-10-28
Survey response — days 1–6 daily, dose 3MedDRA: Injection site pain — Feeling: Fair · Headache, Fatigue or tirednessFree text: Just a little soreness at the injection siteMedDRA releases: 2024-11 · check-in free text available
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-10
- 2021-11-17
- 2021-11-24
- 2021-12-01
- 2021-12-08
- 2022-01-26
- 2022-04-12
-
2022-04-13
Call successfulDoes not wish to fill out VAERS report
- 2022-04-27
-
2022-05-10
Dose 4 — ModernaCo-administered: Tetanus
- 2022-05-20
- 2022-05-24
-
2022-05-31
Survey response — day 21, dose 4MedDRA: Vulvovaginal mycotic infection — Feeling: GoodFree text: A vaginal yeast infection which began one week after second booster. Has cleared up now.MedDRA releases: 2024-11 · check-in free text available
- 2022-06-07
- 2022-06-14
- 2022-06-21
- 2022-08-10
- 2022-11-08
- 2023-05-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-23 | Moderna | |
| 2 | 2021-02-20 | Moderna | |
| 3 | 2021-10-27 | Moderna | No |
| 4 | 2022-05-10 | Moderna | Tetanus |
Call center
1 call center case
1 successful
1 wait over 3 months for a first call
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Only a little bruising at the injection site
Release 8 — 3 months, dose 2
Symptoms: Psoriasis at the base of my hairline and on my left eyelid. Second time for psoriasis at the base of my hairline since completing my vaccination. I have never had psoriasis anywhere before. May or may not be related to vaccine.
Healthcare visit (other): My doctor prescribed a cream.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Just a little soreness at the injection site
Release 11 — day 21, dose 4
Symptoms: A vaginal yeast infection which began one week after second booster. Has cleared up now.
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 | ✓ | ✓ | ✓ |
| SD | Eyelid pain | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Psoriasis | ✓ | ✓ | ✓ |
| SD | Vulvovaginal mycotic infection | · | · | ✓ |
| SRO | Injection site bruising | ✓ | ✓ | ✓ |
| SRO | Injection site pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release