5XU-55219-76957
3 vaccinations
3 coded responses
10 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 890 / NV
- Registered
- 2021-04-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-22
Dose 1 — Moderna
-
2021-04-20
Dose 2 — Moderna
-
2021-04-26
Registered in v-safe
-
2021-04-26
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness, Swelling, Itching · NoneAdult check-in
-
2021-04-27
Health check-in — day 7, dose 2Feeling: Good · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-05-04
- 2021-05-11
- 2021-05-18
-
2021-07-20
Survey response — 3 months, dose 2MedDRA: Cough, Ear discomfort, Headache, Myalgia, Nasopharyngitis — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Felt like i was getting a bad cold, coughing headache, sore muscles plugged ears like i was under water.MedDRA releases: 2024-11 · check-in free text available
- 2021-10-19
-
2021-12-14
Dose 3 — Moderna
- 2022-04-20
-
2022-06-14
Survey response — 6 months, dose 3MedDRA: Arthralgia, Diarrhoea haemorrhagic, Headache, Hypersomnia, Pyrexia, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activitiesFree text: Fever102 terrible headache sore joints, slept lots. Bloody diarrhea. Lasted a week. My home Covid-19 was neg. Fig. It was flu. I also ate Jiff peanutbutter. I read it had salmonella & my jar was recalled. Maybe i had food poisoning.MedDRA releases: 2024-11 · check-in free text available
-
2022-12-14
Survey response — 12 months, dose 3MedDRA: Chest discomfort, Dermatitis allergic, Dyspnoea, Rash, Rash papular, Rash pruritic, Skin exfoliation, Urticaria, Wheezing — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I've developed a horrible allergy to something its like a chemical burn to my face and chest. Itching swelling welts & peeling. Also breathing issues wheezing chest tightness hard to catch breath all this started 2nd week of September.MedDRA releases: 2024-11 · check-in free text available
-
2022-12-14
Report sent to call center — 12 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-12-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-22 | Moderna | |
| 2 | 2021-04-20 | Moderna | |
| 3 | 2021-12-14 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 9 — 3 months, dose 2
Symptoms: Felt like i was getting a bad cold, coughing headache, sore muscles plugged ears like i was under water.
Release 12 — 6 months, dose 3
Symptoms: Fever102 terrible headache sore joints, slept lots. Bloody diarrhea. Lasted a week. My home Covid-19 was neg. Fig. It was flu. I also ate Jiff peanutbutter. I read it had salmonella & my jar was recalled. Maybe i had food poisoning.
Release 12 — 12 months, dose 3
Symptoms: I've developed a horrible allergy to something its like a chemical burn to my face and chest. Itching swelling welts & peeling. Also breathing issues wheezing chest tightness hard to catch breath all this started 2nd week of September.
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 | Arthralgia | · | · | ✓ |
| SD | Chest discomfort | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Dermatitis allergic | · | · | ✓ |
| SD | Diarrhoea haemorrhagic | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SD | Ear discomfort | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Hypersomnia | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Rash papular | · | · | ✓ |
| SD | Rash pruritic | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Skin exfoliation | · | · | ✓ |
| SD | Urticaria | · | · | ✓ |
| SD | Wheezing | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release