63H-56727-00099
5 vaccinations
5 coded responses
40 check-ins
5 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 334 / FL
- Registered
- 2021-01-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-13
Registered in v-safe
-
2021-01-13
Dose 1 — Moderna
- 2021-01-14
- 2021-01-17
- 2021-01-21
- 2021-01-28
- 2021-02-04
-
2021-02-10
Dose 2 — Moderna
-
2021-02-10
Survey response — day 0, dose 2MedDRA: No adverse event — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-12
Survey response — days 1–6 daily, dose 2MedDRA: Influenza like illness, Pyrexia — Feeling: GoodFree text: I missed the check in yesterday I did have flu like symptoms and a slight fever yesterday not todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-16
- 2021-02-17
- 2021-02-25
- 2021-03-04
- 2021-03-11
- 2021-03-18
- 2021-03-24
-
2021-05-12
Survey response — 3 months, dose 2MedDRA: Pain, Pain in extremity — Feeling: GoodFree text: The arm that I got the vaccines in aches when I lift it over my head, Not excruciating pain but Im well aware of where I had the shots.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-08-11
Survey response — 6 months, dose 2MedDRA: Mobility decreased, Pain in extremity — Feeling: GoodFree text: My arm still hurts me where I got the shots sometimes I can barely lift it over my headMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-11-03
Dose 3 — Moderna
- 2022-02-10
-
2022-04-26
Dose 4 — Moderna
-
2022-04-28
Survey response — days 1–6 daily, dose 4MedDRA: Chills, Fatigue — Feeling: Good · Site: Pain · Chills, Fatigue or tirednessFree text: The first night after receiving the shot I had chills and I was fatigued but today I feel just fineMedDRA releases: 2024-11 · check-in free text available
- 2022-04-29
- 2022-04-30
- 2022-05-01
- 2022-05-02
- 2022-05-03
- 2022-05-10
- 2022-05-17
- 2022-05-24
- 2022-05-31
- 2022-06-07
- 2022-07-26
-
2022-09-22
Dose 5 — Moderna
- 2022-09-26
- 2022-09-27
- 2022-09-28
- 2022-09-29
- 2022-10-06
- 2022-10-13
- 2022-10-20
- 2022-10-27
- 2022-11-03
- 2022-12-22
- 2023-03-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-13 | Moderna | |
| 2 | 2021-02-10 | Moderna | |
| 3 | 2021-11-03 | Moderna | No |
| 4 | 2022-04-26 | Moderna | No |
| 5 | 2022-09-22 | Moderna | No |
Free text
Release 4 — day 0, dose 2
Systemic reaction (other): No
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): I missed the check in yesterday I did have flu like symptoms and a slight fever yesterday not today
Release 8 — 3 months, dose 2
Symptoms: The arm that I got the vaccines in aches when I lift it over my head, Not excruciating pain but Im well aware of where I had the shots.
Release 9 — 6 months, dose 2
Symptoms: My arm still hurts me where I got the shots sometimes I can barely lift it over my head
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): The first night after receiving the shot I had chills and I was fatigued but today I feel just fine
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 | Mobility decreased | ✓ | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Influenza like illness | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release