65N-40251-51465
4 vaccinations
3 coded responses
31 check-ins
3 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 630 / MO
- Registered
- 2021-03-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-04
Dose 1 — Moderna
-
2021-03-06
Registered in v-safe
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 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: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-03
- 2021-04-04
-
2021-04-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-07
- 2021-04-09
- 2021-04-15
- 2021-04-22
- 2021-04-29
- 2021-05-06
-
2021-05-13
Survey response — day 42, dose 2MedDRA: Dizziness, Flank pain, Nausea, Unevaluable event — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Pain in my side. Wooziness and nausea periodically over the last weekend. · Healthcare visit (other): Have called to report symptoms. Waiting to hear from primary care doctor.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-13
Report sent to call center — day 42, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-07-01
Survey response — 3 months, dose 2MedDRA: Muscle spasms, Myalgia, Pre-existing disease, Unevaluable event, Walking aid user — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Only muscle pain and spasms. I have spastic paraplegia and typically walk with crutches. · Healthcare visit (other): I havent yet had this appt.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-07-01
Report sent to call center — 3 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-07-23
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-09-30
-
2021-11-05
Dose 3 — Moderna
-
2022-04-01
Survey response — 12 months, dose 2MedDRA: Chills, Pain — Feeling: Good · Be unable to do your normal daily activitiesFree text: After my booster shot I experienced chills and body aches for about a day or so. I had never had any after effects following my two previous vaccinations.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-12
Dose 4 — Moderna
- 2022-04-29
- 2022-05-03
- 2022-05-12
- 2022-05-17
- 2022-05-24
- 2022-07-12
- 2022-10-11
- 2023-04-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-04 | Moderna | |
| 2 | 2021-04-01 | Moderna | |
| 3 | 2021-11-05 | Moderna | No |
| 4 | 2022-04-12 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 8 — day 42, dose 2
Symptoms: Pain in my side. Wooziness and nausea periodically over the last weekend.
Healthcare visit (other): Have called to report symptoms. Waiting to hear from primary care doctor.
Release 9 — 3 months, dose 2
Symptoms: Only muscle pain and spasms. I have spastic paraplegia and typically walk with crutches.
Healthcare visit (other): I havent yet had this appt.
Release 11 — 12 months, dose 2
Symptoms: After my booster shot I experienced chills and body aches for about a day or so. I had never had any after effects following my two previous vaccinations.
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 |
|---|---|---|---|---|
| HCVO | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Flank pain | ✓ | ✓ | ✓ |
| SD | Muscle spasms | ✓ | ✓ | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Walking aid user | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release