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5ZC-23671-08016

4 vaccinations 5 coded responses 40 check-ins 5 free-text entries 1 call case
Sex
Female
Age at first dose
66+
ZIP prefix
537 / WI
Registered
2021-02-13
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-12
    Dose 1 — Moderna
  2. 2021-02-13
    Registered in v-safe
  3. 2021-02-13
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  4. 2021-02-14
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  5. 2021-02-15
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-02-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-02-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-02-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-02-19
    Survey response — day 7, dose 1
    MedDRA: Flatulence — Feeling: Fair · Headache, Nausea · Be unable to do your normal daily activities
    Free text: I feel Im not we do to ingesting something. Feel very gassy.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-02-26
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-03-05
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-03-12
    Dose 2 — Moderna
  13. 2021-03-12
    Health check-in — day 0, dose 2
    Feeling: Good · None
    Adult check-in
  14. 2021-03-13
    Survey response — days 1–6 daily, dose 2
    MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Free text: Slightly dizzy
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-03-14
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  16. 2021-03-15
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-03-16
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Headache
    Adult check-in
  18. 2021-03-17
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-03-18
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-03-19
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  21. 2021-03-26
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-04-02
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-04-09
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-04-16
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-04-23
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-06-11
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-09-10
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-10-22
    Dose 3 — Moderna
  29. 2021-10-28
    Survey response — days 1–6 daily, dose 3
    MedDRA: Axillary pain, Chills, Headache, Injection site pain, Malaise, Pain, Pyrexia — Feeling: Good · Site: Pain · Be unable to do your normal daily activities
    Free text: When I got my booster on October 22, 2021 I became very sick that night but cdc did not text me. I had HA's, fever, chills, pain at injection site and pain down side of body starting at axillary area going down. All over body aches. Lasted over 48hrs
    MedDRA releases: 2024-11 · check-in free text available
  30. 2021-10-29
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  31. 2021-11-05
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  32. 2021-11-12
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  33. 2021-11-19
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  34. 2021-11-26
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  35. 2021-12-03
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  36. 2022-01-21
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  37. 2022-03-30
    Dose 4 — Moderna
  38. 2022-04-15
    Survey response — day 14, dose 4
    MedDRA: Dizziness — 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 visit
    Free text: Lightheaded But I believe not related to vaccines Started February 2022
    MedDRA releases: 2024-11 · check-in free text available
  39. 2022-04-15
    Report sent to call center — day 14, dose 4
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  40. 2022-04-20
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  41. 2022-04-21
    Call successful
    Not applicable - Accidental Reporting
  42. 2022-04-27
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  43. 2022-05-04
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  44. 2022-05-11
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  45. 2022-06-29
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  46. 2022-09-28
    Survey response — 6 months, dose 4
    MedDRA: SARS-CoV-2 test positive — Feeling: Good · Be unable to do your normal daily activities
    Free text: Positive Covid pcr test
    MedDRA releases: 2024-11 · check-in free text available
  47. 2023-03-30
    Health check-in — 12 months, dose 4
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-12Moderna
22021-03-12Moderna
32021-10-22Moderna No
42022-03-30Moderna No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 4 — day 7, dose 1

2021-02-19

Systemic reaction (other): I feel Im not we do to ingesting something. Feel very gassy.

Release 5 — days 1–6 daily, dose 2

2021-03-13

Systemic reaction (other): Slightly dizzy

Release 10 — days 1–6 daily, dose 3

2021-10-28

Systemic reaction (other): When I got my booster on October 22, 2021 I became very sick that night but cdc did not text me. I had HA's, fever, chills, pain at injection site and pain down side of body starting at axillary area going down. All over body aches. Lasted over 48hrs cut off by CDC

Release 11 — day 14, dose 4

2022-04-15

Symptoms: Lightheaded But I believe not related to vaccines Started February 2022

Release 12 — 6 months, dose 4

2022-09-28

Symptoms: Positive Covid pcr test

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
SDDizziness · · ✓
SDSARS-CoV-2 test positive · · ✓
SROAxillary pain · · ✓
SROChills · · ✓
SRODizziness ✓ ✓ ✓
SROFlatulence ✓ ✓ ✓
SROHeadache · · ✓
SROInjection site pain · · ✓
SROMalaise · · ✓
SROPain · · ✓
SROPyrexia · · ✓

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