5ZW-30185-42113
4 vaccinations
7 coded responses
53 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 371 / TN
- Registered
- 2021-03-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-04
Dose 1 — Moderna
-
2021-03-05
Registered in v-safe
- 2021-03-05
- 2021-03-06
-
2021-03-07
Survey response — days 1–6 daily, dose 1MedDRA: Headache — Feeling: Good · HeadacheFree text: Headache probably due to 30 mile bike ride on gravel. :)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-08
- 2021-03-09
-
2021-03-10
Survey response — days 1–6 daily, dose 1MedDRA: Therapeutic response unexpected — Feeling: GoodFree text: Hiked 5 miles today. Feel great.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-11
- 2021-03-18
- 2021-03-25
-
2021-04-01
Dose 2 — Moderna
- 2021-04-01
-
2021-04-02
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-03
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2021-04-04
Survey response — days 1–6 daily, dose 2MedDRA: Axillary pain, Oedema peripheral, Tenderness — Feeling: Good · Site: PainFree text: Pain and fullness in my armpit of the arm where I received the injection. Cannot palpate a node or a knot. Just tenderness.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-05
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: GoodFree text: All soreness and fullness feeling in arm pit is gone todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-15
- 2021-04-22
- 2021-05-01
- 2021-05-06
- 2021-05-13
- 2021-07-02
- 2021-09-30
-
2021-10-28
Dose 3 — Pfizer-BioNTech
- 2021-10-29
- 2021-10-30
-
2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Axillary pain, Vaccine positive rechallenge — Feeling: GoodFree text: Sore arm pit. Happened with last vaccine.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-11
- 2021-11-18
- 2021-11-25
- 2021-12-03
-
2021-12-09
Survey response — day 42, dose 3MedDRA: Cough, Oropharyngeal pain, Pre-existing disease, Respiratory tract congestion, SARS-CoV-2 test negative, Upper respiratory tract infection — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Sore throat, cough and congestion-just a basic upper respiratory infection. Not unusual for me this time of year. Negative Covid-19 PCR test on 12/7MedDRA releases: 2024-11 · check-in free text available
- 2022-01-27
- 2022-04-28
-
2022-10-03
Dose 4 — ModernaCo-administered: Flu
- 2022-10-03
-
2022-10-04
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fever · Muscle or body achesAdult check-in
- 2022-10-05
- 2022-10-06
- 2022-10-07
- 2022-10-08
- 2022-10-09
- 2022-10-10
- 2022-10-17
- 2022-10-25
-
2022-10-31
Survey response — day 28, dose 4MedDRA: Influenza — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: I have the fluMedDRA releases: 2024-11 · check-in free text available
-
2022-10-31
Report sent to call center — day 28, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-11-01
-
2022-11-01
Call successfulNot applicable - Accidental Reporting
- 2022-11-07
- 2022-11-14
- 2023-01-02
- 2023-04-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-04 | Moderna | |
| 2 | 2021-04-01 | Moderna | |
| 3 | 2021-10-28 | Pfizer-BioNTech | No |
| 4 | 2022-10-03 | Moderna | Flu |
Call center
1 call center case
1 successful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Headache probably due to 30 mile bike ride on gravel. :)
Systemic reaction (other): Hiked 5 miles today. Feel great.
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Pain and fullness in my armpit of the arm where I received the injection. Cannot palpate a node or a knot. Just tenderness.
Systemic reaction (other): All soreness and fullness feeling in arm pit is gone today
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Sore arm pit. Happened with last vaccine.
Release 10 — day 42, dose 3
Symptoms: Sore throat, cough and congestion-just a basic upper respiratory infection. Not unusual for me this time of year. Negative Covid-19 PCR test on 12/7
Release 12 — day 28, dose 4
Symptoms: I have the flu
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 | Cough | · | · | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
| SRO | Axillary pain | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Oedema peripheral | ✓ | ✓ | ✓ |
| SRO | Tenderness | ✓ | ✓ | ✓ |
| SRO | Therapeutic response unexpected | ✓ | ✓ | ✓ |
| SRO | Vaccine positive rechallenge | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release