5T6-18026-47838
3 vaccinations
5 coded responses
38 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 199 / DE
- Registered
- 2021-03-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-26
Dose 1 — Moderna
-
2021-03-30
Registered in v-safe
- 2021-03-30
-
2021-03-31
Survey response — days 1–6 daily, dose 1MedDRA: Decreased appetite — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tirednessFree text: Poor appetiteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-01
Health check-in — days 1–6 daily, dose 1Feeling: Good · Chills, Headache, Fatigue or tirednessAdult check-in
-
2021-04-02
Health check-in — day 7, dose 1Feeling: Good · Chills, Headache, Muscle or body achesAdult check-in
- 2021-04-09
- 2021-04-16
-
2021-04-23
Dose 2 — Moderna
- 2021-04-23
-
2021-04-24
Survey response — days 1–6 daily, dose 2MedDRA: Mouth swelling, Pharyngeal swelling, Swollen tongue — Feeling: Good · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tirednessFree text: My mouth tongue and throat were swollen when I went to bed. I dont know if its related to the vacation, but it was a bit scary.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-25
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Swelling · Headache, Fatigue or tirednessAdult check-in
-
2021-04-26
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Itching · Fatigue or tirednessAdult check-in
- 2021-04-27
- 2021-04-28
-
2021-04-29
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Fatigue or tirednessAdult check-in
- 2021-04-30
- 2021-05-07
- 2021-05-14
- 2021-05-21
- 2021-05-28
-
2021-06-04
Survey response — day 42, dose 2MedDRA: Decreased appetite, Fatigue, Headache, Insomnia — Feeling: FairFree text: Not sleeping well; very tired; poor apitite; and headaches.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-23
- 2021-10-22
- 2022-04-23
-
2022-05-11
Dose 3 — Pfizer-BioNTech
- 2022-05-11
-
2022-05-12
Survey response — days 1–6 daily, dose 3MedDRA: No adverse event — Feeling: Good · Site: Pain · Chills, HeadacheFree text: NoMedDRA releases: 2024-11 · check-in free text available
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2022-05-13
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Redness · Fever · ChillsAdult check-in
-
2022-05-14
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Redness · Fatigue or tirednessAdult check-in
-
2022-05-15
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Itching · Fatigue or tirednessAdult check-in
- 2022-05-16
- 2022-05-17
- 2022-05-18
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2022-05-26
Survey response — day 14, dose 3MedDRA: Decreased appetite, Fatigue, Headache, Immune system disorder, Office visit, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Exhaustion, headaches and low appetite. I don't think it's related to the vaccine, rather more like low immune system do to auto immune disease. But just in case it's common, I'm reporting it to you. · Healthcare visit (other): Saw my primary care doctor.MedDRA releases: 2024-11 · check-in free text available
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2022-05-26
Report sent to call center — day 14, dose 3Get care from a doctor or other healthcare professional1 call case(s)
-
2022-05-27
Call successfulNot applicable - Accidental Reporting
- 2022-06-02
- 2022-06-08
- 2022-06-15
- 2022-06-22
- 2022-08-10
- 2022-11-10
- 2023-05-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-26 | Moderna | |
| 2 | 2021-04-23 | Moderna | |
| 3 | 2022-05-11 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Poor appetite
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): My mouth tongue and throat were swollen when I went to bed. I dont know if its related to the vacation, but it was a bit scary.
Release 8 — day 42, dose 2
Symptoms: Not sleeping well; very tired; poor apitite; and headaches.
Release 11 — days 1–6 daily, dose 3
Systemic reaction (other): No
Release 11 — day 14, dose 3
Symptoms: Exhaustion, headaches and low appetite. I don't think it's related to the vaccine, rather more like low immune system do to auto immune disease. But just in case it's common, I'm reporting it to you.
Healthcare visit (other): Saw my primary care doctor.
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 | Decreased appetite | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Immune system disorder | · | · | ✓ |
| SD | Insomnia | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SRO | Decreased appetite | ✓ | ✓ | ✓ |
| SRO | Mouth swelling | ✓ | ✓ | ✓ |
| SRO | No adverse event | · | · | ✓ |
| SRO | Pharyngeal swelling | ✓ | ✓ | ✓ |
| SRO | Swollen tongue | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release