5QU-74637-48268
2 vaccinations
5 coded responses
23 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 678 / KS
- Registered
- 2021-02-12
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-12
Registered in v-safe
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2021-02-12
Dose 1 — Moderna
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2021-02-12
Survey response — day 0, dose 1MedDRA: Headache, Nausea, SARS-CoV-2 test negative, Self-medication — Feeling: Fair · Site: Pain · HeadacheFree text: I woke up this morning with horrible headache (never get them) and some nausea. I took one Motrin at 1:00; I received the vaccine at 4:00. I had also been tested for COVID around 11 this morning with a negative result. My headache came back a little tonight; so, I am not sure whether the vaccine actually caused headache. My daughter was throwing up on Tuesday with diarrhea on Wednesday. She, her 5 year old twin brother, myself, and my husband also all tested negative for COVID on Wednesday.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-13
- 2021-02-14
- 2021-02-15
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-26
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2021-03-09
Survey response — day 21, dose 1MedDRA: Headache, SARS-CoV-2 test negative — Feeling: GoodFree text: Just had a weird headache on Wednesday night and Thursday of last week. I had sharp stabbing pains in the side of my head. I rarely get any headaches., I have had this type less than a half a dozen times in my life. I had a neg rapid COVID test friMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-10
Dose 2 — Moderna
- 2021-03-10
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2021-03-11
Survey response — days 1–6 daily, dose 2MedDRA: Back pain, Body temperature increased, Pain, Pain in extremity — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, NauseaFree text: Fever did get up to 99.3. All symptoms were very minor. Even arm is less soar than the first shot. All other symptoms cleared in about 24 hours after beginning about 12 hours after vaccination. My back is the only thing that still feels a little soar. I also had pain under my right breast at the bra line throughout night and todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-12
Survey response — days 1–6 daily, dose 2MedDRA: Back pain — Feeling: GoodFree text: Lower back ache still seems to be there slightly when moving certain wayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-13
- 2021-03-16
- 2021-03-17
- 2021-03-24
- 2021-03-31
- 2021-04-07
- 2021-04-15
- 2021-04-21
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2021-06-09
Survey response — 3 months, dose 2MedDRA: Cardiac disorder, Medical counselling, White blood cell count decreased — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Had some concerns with my heart one evening. Followed up with doctor; found a low white blood count that hasnt been explained. Will be following up with (b)(6) in August. Someone should follow up via a phone call to understand my responses beMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-06-09
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-09-12
- 2021-11-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-12 | Moderna | |
| 2 | 2021-03-10 | Moderna |
Call center
1 call center case
1 unsuccessful
1 wait over 3 months for a first call
Free text
Release 4 — day 0, dose 1
Systemic reaction (other): I woke up this morning with horrible headache (never get them) and some nausea. I took one Motrin at 1:00; I received the vaccine at 4:00. I had also been tested for COVID around 11 this morning with a negative result. My headache came back a little tonight; so, I am not sure whether the vaccine actually caused headache. My daughter was throwing up on Tuesday with diarrhea on Wednesday. She, her 5 year old twin brother, myself, and my husband also all tested negative for COVID on Wednesday.
Release 5 — day 21, dose 1
Symptoms: Just had a weird headache on Wednesday night and Thursday of last week. I had sharp stabbing pains in the side of my head. I rarely get any headaches., I have had this type less than a half a dozen times in my life. I had a neg rapid COVID test fri cut off by CDC
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Fever did get up to 99.3. All symptoms were very minor. Even arm is less soar than the first shot. All other symptoms cleared in about 24 hours after beginning about 12 hours after vaccination. My back is the only thing that still feels a little soar. I also had pain under my right breast at the bra line throughout night and today
Systemic reaction (other): Lower back ache still seems to be there slightly when moving certain way
Release 9 — 3 months, dose 2
Symptoms: Had some concerns with my heart one evening. Followed up with doctor; found a low white blood count that hasnt been explained. Will be following up with (b)(6) in August. Someone should follow up via a phone call to understand my responses be
redacted (b)(6)
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 | Cardiac disorder | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Medical counselling | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SD | White blood cell count decreased | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Body temperature increased | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release