67J-14878-13787
5 vaccinations
7 coded responses
48 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 856 / AZ
- Registered
- 2021-03-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-25
Dose 1 — Moderna
-
2021-03-25
Dose 2 — Moderna
-
2021-03-29
Registered in v-safe
-
2021-03-29
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Itching · NoneAdult check-in
- 2021-03-30
- 2021-03-31
- 2021-04-01
- 2021-04-08
- 2021-04-15
- 2021-04-22
- 2021-04-29
- 2021-05-06
- 2021-06-24
-
2021-09-23
Survey response — 6 months, dose 2MedDRA: Diplopia — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: One episode of double vision for about 15 minutes. Had MRI and heart check and all is well.MedDRA releases: 2024-11 · check-in free text available
-
2021-09-23
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-09-27
-
2021-09-27
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-11-01
Dose 3 — Moderna
-
2021-11-03
Survey response — days 1–6 daily, dose 3MedDRA: Pain — Feeling: GoodFree text: The day after my booster I had some achingMedDRA releases: 2024-11 · check-in free text available
- 2021-11-04
- 2021-11-05
-
2021-11-06
Survey response — days 1–6 daily, dose 3MedDRA: Unevaluable event — Feeling: FairFree text: Think I have a cold. Babysat this week and my grandson was ill. Not related to the vaccine.MedDRA releases: 2024-11 · check-in free text available
-
2021-11-07
Survey response — days 1–6 daily, dose 3MedDRA: Bronchitis — Feeling: PoorFree text: Seem to have bronchitis caught from my grandson. Not covid/vaccine related.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2021-12-13
- 2022-01-31
- 2022-05-02
-
2022-05-25
Dose 4 — Moderna
- 2022-05-25
-
2022-05-26
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
- 2022-05-27
-
2022-05-28
Survey response — days 1–6 daily, dose 4MedDRA: Injection site discomfort — Feeling: GoodFree text: Injection site is sore but not painfulMedDRA releases: 2024-11 · check-in free text available
- 2022-05-29
- 2022-05-30
- 2022-05-31
- 2022-06-01
- 2022-06-08
- 2022-06-15
- 2022-06-22
- 2022-06-29
- 2022-07-06
- 2022-08-24
-
2022-09-28
Dose 5 — Moderna
- 2022-10-03
-
2022-10-04
Survey response — days 1–6 daily, dose 5MedDRA: Influenza like illness, Pain — Feeling: GoodFree text: The night and next day after the vaccine I had aching all over like the flu but it went away that afternoon.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-05
- 2022-10-12
- 2022-10-19
- 2022-10-26
- 2022-11-02
- 2022-11-09
-
2022-12-28
Survey response — 3 months, dose 5MedDRA: Cough, Nasopharyngitis — Feeling: GoodFree text: Cold and coughMedDRA releases: 2024-11 · check-in free text available
- 2023-03-29
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-25 | Moderna | |
| 2 | 2021-03-25 | Moderna | |
| 3 | 2021-11-01 | Moderna | No |
| 4 | 2022-05-25 | Moderna | No |
| 5 | 2022-09-28 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 9 — 6 months, dose 2
Symptoms: One episode of double vision for about 15 minutes. Had MRI and heart check and all is well.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): The day after my booster I had some aching
Systemic reaction (other): Think I have a cold. Babysat this week and my grandson was ill. Not related to the vaccine.
Systemic reaction (other): Seem to have bronchitis caught from my grandson. Not covid/vaccine related.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Injection site is sore but not painful
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): The night and next day after the vaccine I had aching all over like the flu but it went away that afternoon.
Release 12 — 3 months, dose 5
Symptoms: Cold and cough
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 | Diplopia | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SRO | Bronchitis | · | · | ✓ |
| SRO | Influenza like illness | · | · | ✓ |
| SRO | Injection site discomfort | · | · | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release