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5Z5-15894-62538

2 vaccinations 8 coded responses 26 check-ins 8 free-text entries 0 call cases
Sex
Female
Age at first dose
56-60
ZIP prefix
970 / OR
Registered
2021-01-09
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-09
    Registered in v-safe
  2. 2021-01-09
    Dose 1 — Moderna
  3. 2021-01-09
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-01-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  5. 2021-01-11
    Survey response — days 1–6 daily, dose 1
    MedDRA: Lymphadenopathy, Swollen tongue — Feeling: Good · Site: Pain · Fatigue or tiredness
    Free text: Swollen submandibular lump nodes both sides. Slight posterior tongue swelling near the base on lateral borders.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-01-12
    Survey response — days 1–6 daily, dose 1
    MedDRA: Swollen tongue — Feeling: Good · Site: Pain
    Free text: Tongue still sligg DH rly swollen on posterior lateral borders.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-01-13
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  8. 2021-01-14
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-01-15
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-01-16
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  11. 2021-01-23
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-01-30
    Survey response — day 21, dose 1
    MedDRA: Headache, Heart rate increased — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Headache in frontal portion of my head. Rapid heart beat earlier today.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-02-06
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  14. 2021-02-07
    Dose 2 — Moderna
  15. 2021-02-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  16. 2021-02-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Redness, Swelling · None
    Adult check-in
  17. 2021-02-10
    Survey response — days 1–6 daily, dose 2
    MedDRA: Unevaluable event — Feeling: Good · Site: Pain
    Free text: Left infraorbital notch, plus lower lid margin and surrounding skin
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-02-11
    Survey response — days 1–6 daily, dose 2
    MedDRA: Eyelid infection — Feeling: Good
    Free text: Left lower eyelid infection
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  19. 2021-02-12
    Survey response — days 1–6 daily, dose 2
    MedDRA: Eyelid infection — Feeling: Good
    Free text: Left lower eyelid infection
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-02-13
    Survey response — days 1–6 daily, dose 2
    MedDRA: Eyelid infection — Feeling: Good
    Free text: Left eyelid infection
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-02-14
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  22. 2021-02-21
    Survey response — day 14, dose 2
    MedDRA: Headache — Feeling: Good · Be unable to work
    Free text: Headache on Wednesday, Thursday, and Friday that started mid morning and lasted until about 4:00 each day.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  23. 2021-02-28
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-03-07
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-03-14
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-03-21
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-05-09
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-08-08
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  29. 2022-02-07
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-09Moderna
22021-02-07Moderna

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-11

Systemic reaction (other): Swollen submandibular lump nodes both sides. Slight posterior tongue swelling near the base on lateral borders.

2021-01-12

Systemic reaction (other): Tongue still sligg DH rly swollen on posterior lateral borders.

Release 3 — day 21, dose 1

2021-01-30

Symptoms: Headache in frontal portion of my head. Rapid heart beat earlier today.

Release 3 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): Left infraorbital notch, plus lower lid margin and surrounding skin

Release 4 — days 1–6 daily, dose 2

2021-02-11

Systemic reaction (other): Left lower eyelid infection

2021-02-12

Systemic reaction (other): Left lower eyelid infection

2021-02-13

Systemic reaction (other): Left eyelid infection

Release 4 — day 14, dose 2

2021-02-21

Symptoms: Headache on Wednesday, Thursday, and Friday that started mid morning and lasted until about 4:00 each day.

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
SDHeadache ✓ ✓ ✓
SDHeart rate increased ✓ ✓ ✓
SROEyelid infection ✓ ✓ ✓
SROLymphadenopathy ✓ ✓ ✓
SROMandibular mass ○ ○ ○
SROSwollen tongue ✓ ✓ ✓
SROUnevaluable event ✓ ✓ ✓

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