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5YJ-54935-00861

3 vaccinations 4 coded responses 9 check-ins 4 free-text entries 0 call cases
Sex
Female
Age at first dose
56-60
ZIP prefix
974 / OR
Registered
2021-05-17
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-04-02
    Dose 1 — Moderna
  2. 2021-04-30
    Dose 2 — Moderna
  3. 2021-05-17
    Registered in v-safe
  4. 2021-05-17
    Health check-in — day 14, dose 2
    Feeling: Fair
    Adult check-in
  5. 2021-05-21
    Survey response — day 21, dose 2
    MedDRA: Diarrhoea, Fatigue, Headache, Insomnia, Pain in extremity, Peripheral swelling, Vertigo — Feeling: Good
    Free text: I only marked yes because I havent been able to put in any symptoms.After 1st shot-sore armAfter 2nd shot-sore & swollen arm, headache, 1 bout of diarrhea, 1 night of insomnia, vertigo for 16 days after 3rd day post shot aided by Diphenhydramine
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-05-28
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  7. 2021-06-04
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  8. 2021-06-11
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  9. 2021-07-30
    Survey response — 3 months, dose 2
    MedDRA: Bladder discomfort, Diarrhoea, Dyspepsia, Influenza like illness, SARS-CoV-2 test negative, Vomiting — Feeling: Good
    Free text: Felt like flu or food poisoning for two hours with highly acidic vomit and diarrhea. Felt like it scalded my bladder and stomach for a week. No fever. Covid test negative.
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  10. 2021-10-29
    Survey response — 6 months, dose 2
    MedDRA: Head discomfort, Vertigo — Feeling: Good
    Free text: Vertigo came back for a day. Back of my head feels weird sometimes like after the second vaccine.
    MedDRA releases: 2024-11 · check-in free text available
  11. 2021-12-27
    Dose 3 — Moderna
  12. 2022-06-27
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  13. 2022-12-27
    Survey response — 12 months, dose 3
    MedDRA: COVID-19 — Feeling: Good
    Free text: I got Covid on November 26th.
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-04-02Moderna
22021-04-30Moderna
32021-12-27Moderna No

Free text

Release 8 — day 21, dose 2

2021-05-21

Symptoms: I only marked yes because I havent been able to put in any symptoms.After 1st shot-sore armAfter 2nd shot-sore & swollen arm, headache, 1 bout of diarrhea, 1 night of insomnia, vertigo for 16 days after 3rd day post shot aided by Diphenhydramine

Release 9 — 3 months, dose 2

2021-07-30

Symptoms: Felt like flu or food poisoning for two hours with highly acidic vomit and diarrhea. Felt like it scalded my bladder and stomach for a week. No fever. Covid test negative.

Release 10 — 6 months, dose 2

2021-10-29

Symptoms: Vertigo came back for a day. Back of my head feels weird sometimes like after the second vaccine.

Release 12 — 12 months, dose 3

2022-12-27

Symptoms: I got Covid on November 26th.

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

FieldPreferred term2021-092023-042024-11
SDBladder discomfort ✓ · ✓
SDCOVID-19 · · ✓
SDDiarrhoea ✓ ✓ ✓
SDDyspepsia ✓ · ✓
SDFatigue ✓ ✓ ✓
SDHead discomfort · · ✓
SDHeadache ✓ ✓ ✓
SDInfluenza like illness ✓ · ✓
SDInsomnia ✓ ✓ ✓
SDPain in extremity ✓ ✓ ✓
SDPeripheral swelling ✓ ✓ ✓
SDSARS-CoV-2 test negative ✓ · ✓
SDVertigo ✓ ✓ ✓
SDVomiting ✓ · ✓

✓ active code · ○ coded but marked inactive · blank = not in that release