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5YT-28051-10514

2 vaccinations 6 coded responses 20 check-ins 6 free-text entries 0 call cases
Sex
Female
Age at first dose
61-65
ZIP prefix
826 / WY
Registered
2021-03-04
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-04
    Registered in v-safe
  2. 2021-03-04
    Dose 1 — Moderna
  3. 2021-03-04
    Survey response — day 0, dose 1
    MedDRA: Fatigue, Headache — Feeling: Good · Headache, Fatigue or tiredness
    Free text: Headache and fatigue were mild
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-05
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Headache, Fatigue or tiredness
    Adult check-in
  5. 2021-03-06
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  6. 2021-03-07
    Survey response — days 1–6 daily, dose 1
    MedDRA: Upper-airway cough syndrome — Feeling: Good · Fatigue or tiredness
    Free text: Nose drip periodically the last 3 days
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-03-08
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-04-01
    Dose 2 — Moderna
  9. 2021-04-01
    Health check-in — day 0, dose 2
    Feeling: Good · None
    Adult check-in
  10. 2021-04-02
    Survey response — days 1–6 daily, dose 2
    MedDRA: Vision blurred — Feeling: Poor · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Free text: My right eye had blurred vision for about 6 hours
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-04-03
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  12. 2021-04-04
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  13. 2021-04-05
    Survey response — days 1–6 daily, dose 2
    MedDRA: Rash macular — Feeling: Good · Rash, not including the immediate area around the injection site
    Free text: Red blotch on left side of stomach might be insect bite not sure yet
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-04-06
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  15. 2021-04-07
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  16. 2021-04-08
    Health check-in — day 7, dose 2
    Feeling: Fair · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  17. 2021-04-15
    Survey response — day 14, dose 2
    MedDRA: Office visit, Skin mass, Tenderness — Feeling: Good
    Free text: A under skin nodule on lower right leg that is tender, seen doctor will do ultra sound next week if it doesn't recede
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-04-22
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-04-29
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-05-06
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-07-01
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-09-30
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  23. 2022-04-01
    Survey response — 12 months, dose 2
    MedDRA: Arthritis, Asthenia, Dysmenorrhoea, Malaise, Pre-existing disease — Feeling: Good
    Free text: Menstrual like cramps ...not as much energy...arthritis seems more advanced...1st two shots ok. Booster i got sick from and just not as energetic as i was prior to it
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-03-04Moderna
22021-04-01Moderna

Free text

Release 5 — day 0, dose 1

2021-03-04

Systemic reaction (other): Headache and fatigue were mild

Release 5 — days 1–6 daily, dose 1

2021-03-07

Systemic reaction (other): Nose drip periodically the last 3 days

Release 6 — days 1–6 daily, dose 2

2021-04-02

Systemic reaction (other): My right eye had blurred vision for about 6 hours

2021-04-05

Systemic reaction (other): Red blotch on left side of stomach might be insect bite not sure yet

Release 7 — day 14, dose 2

2021-04-15

Symptoms: A under skin nodule on lower right leg that is tender, seen doctor will do ultra sound next week if it doesn't recede

Release 11 — 12 months, dose 2

2022-04-01

Symptoms: Menstrual like cramps ...not as much energy...arthritis seems more advanced...1st two shots ok. Booster i got sick from and just not as energetic as i was prior to it

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
SDArthritis · · ✓
SDAsthenia · · ✓
SDDysmenorrhoea · · ✓
SDMalaise · · ✓
SDOffice visit ✓ ✓ ✓
SDPre-existing disease · · ✓
SDSkin mass ✓ ✓ ✓
SDTenderness ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SRORash macular ✓ ✓ ✓
SROUpper-airway cough syndrome ✓ ✓ ✓
SROVision blurred ✓ ✓ ✓

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