63Z-10407-74852
2 vaccinations
5 coded responses
16 check-ins
5 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 104 / NY
- Registered
- 2021-02-18
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-18
Registered in v-safe
-
2021-02-18
Dose 1 — Moderna
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2021-02-18
Survey response — day 0, dose 1MedDRA: Eye pain, Myalgia — Feeling: Good · Site: Pain · Muscle or body achesFree text: I felt slightly achy in my eye muscles, but it is mostly better.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-19
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · None · Be unable to do your normal daily activitiesAdult check-in
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2021-02-21
Survey response — days 1–6 daily, dose 1MedDRA: Arthralgia, Back pain, Diarrhoea, Fatigue, Pain in extremity, Pelvic pain, Somnolence — Feeling: Good · DiarrheaFree text: Yesterday I was tired and sleepy. I awoke yesterday with lower back and pelvic aches, both upper arms and knees were also aching. I basically just wanted to stay in bed. I had loose stools today, but maybe it was from eating a bag of " smart sweets ".MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-22
- 2021-02-23
- 2021-02-24
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2021-02-25
Survey response — day 7, dose 1MedDRA: Somnolence — Feeling: GoodFree text: I get sleepy earlier than usual since the time that I received the vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-07
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2021-03-13
Survey response — day 21, dose 1MedDRA: Mucous stools — Feeling: GoodFree text: Mucous in my stool for several days now.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-18
Dose 2 — Moderna
- 2021-03-27
- 2021-04-02
- 2021-04-15
- 2021-04-22
- 2021-04-29
- 2021-06-19
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2021-09-16
Survey response — 6 months, dose 2MedDRA: Abdominal discomfort, Muscle spasms, Pain — Feeling: FairFree text: Abdominal discomfort/ brief painful spasmsMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-18 | Moderna | |
| 2 | 2021-03-18 | Moderna |
Free text
Release 4 — day 0, dose 1
Systemic reaction (other): I felt slightly achy in my eye muscles, but it is mostly better.
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Yesterday I was tired and sleepy. I awoke yesterday with lower back and pelvic aches, both upper arms and knees were also aching. I basically just wanted to stay in bed. I had loose stools today, but maybe it was from eating a bag of " smart sweets ".
Release 4 — day 7, dose 1
Systemic reaction (other): I get sleepy earlier than usual since the time that I received the vaccine.
Release 5 — day 21, dose 1
Symptoms: Mucous in my stool for several days now.
Release 9 — 6 months, dose 2
Symptoms: Abdominal discomfort/ brief painful spasms
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 | Abdominal discomfort | · | · | ✓ |
| SD | Mucous stools | ✓ | ✓ | ✓ |
| SD | Muscle spasms | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Diarrhoea | ✓ | ✓ | ✓ |
| SRO | Eye pain | ✓ | ✓ | ○ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Myalgia | · | · | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Pelvic pain | ✓ | ✓ | ✓ |
| SRO | Somnolence | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release