6AU-19204-67114
4 vaccinations
6 coded responses
54 check-ins
6 free-text entries
1 call case
- Sex
- —
- Age at first dose
- 66+
- ZIP prefix
- 958 / CA
- Registered
- 2021-02-12
- Relationship
- Self
- Race
- Multiracial
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-12
Registered in v-safe
-
2021-02-12
Dose 1 — Moderna
- 2021-02-12
- 2021-02-13
- 2021-02-14
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2021-02-15
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-16
-
2021-02-17
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Joint pains, Fatigue or tirednessAdult check-in
-
2021-02-18
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-02-19
Health check-in — day 7, dose 1Feeling: Fair · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-26
- 2021-03-05
-
2021-03-12
Dose 2 — Moderna
-
2021-03-13
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-03-14
Survey response — days 1–6 daily, dose 2MedDRA: Abdominal pain upper, Aspiration, Flatulence, Retching — Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to do your normal daily activitiesFree text: Wrenching Vomit. Stomach pain with excessive gas.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-26
- 2021-04-02
- 2021-04-09
- 2021-04-16
- 2021-04-23
- 2021-06-11
-
2021-09-10
Dose 3 — Moderna
- 2021-09-10
- 2021-09-10
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2021-09-11
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
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2021-09-12
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2021-09-13
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain, Redness, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2021-09-14
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2021-09-15
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
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2021-09-16
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
-
2021-09-17
Health check-in — day 7, dose 3Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
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2021-09-24
Survey response — day 14, dose 3MedDRA: Chills, Nausea, Neuralgia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Nerve pain in neck, back, legs, and feet. Chills and nausea.MedDRA releases: 2024-11 · check-in free text available
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2021-10-01
Survey response — day 21, dose 3MedDRA: Back pain, Dysuria, Hypoaesthesia, Neck pain, Neuralgia, Pain, Pain in extremity, Urine output decreased — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Back, leg, and foot pain. Pinching and numbness. Additional neck nerve pain. Difficult to none urinationMedDRA releases: 2024-11 · check-in free text available
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2021-10-08
Survey response — day 28, dose 3MedDRA: Heart rate increased, Rash — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Rash on ankle and leg. Heart has rapid and hard beating.MedDRA releases: 2024-11 · check-in free text available
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2021-10-15
Survey response — day 35, dose 3MedDRA: Back pain, Bone pain, Myalgia, Neuralgia — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Nerve, bone, and muscle pain in feet, back, neck, shoulders, arms and hands.MedDRA releases: 2024-11 · check-in free text available
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2021-10-22
Survey response — day 42, dose 3MedDRA: Cardiac disorder, Electrocardiogram ambulatory abnormal, Office visit, Ventricular extrasystoles — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Heart problems · Healthcare visit (other): Saw primary care doctor. Had heart monitor and scan. Heart showed rare pvc's and beats.MedDRA releases: 2024-11 · check-in free text available
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2021-10-22
Report sent to call center — day 42, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2021-10-26
- 2021-12-12
- 2022-03-11
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2022-07-13
Dose 4 — Moderna
- 2022-07-13
- 2022-07-14
- 2022-07-15
- 2022-07-16
- 2022-07-17
- 2022-07-18
- 2022-07-19
- 2022-07-20
- 2022-07-27
- 2022-08-03
- 2022-08-10
- 2022-08-17
- 2022-08-24
- 2022-10-12
- 2023-01-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-12 | Moderna | |
| 2 | 2021-03-12 | Moderna | |
| 3 | 2021-09-10 | Moderna | No |
| 4 | 2022-07-13 | Moderna | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Wrenching Vomit. Stomach pain with excessive gas.
Release 9 — day 14, dose 3
Symptoms: Nerve pain in neck, back, legs, and feet. Chills and nausea.
Release 9 — day 21, dose 3
Symptoms: Back, leg, and foot pain. Pinching and numbness. Additional neck nerve pain. Difficult to none urination
Release 10 — day 28, dose 3
Symptoms: Rash on ankle and leg. Heart has rapid and hard beating.
Release 10 — day 35, dose 3
Symptoms: Nerve, bone, and muscle pain in feet, back, neck, shoulders, arms and hands.
Release 10 — day 42, dose 3
Symptoms: Heart problems
Healthcare visit (other): Saw primary care doctor. Had heart monitor and scan. Heart showed rare pvc's and beats.
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 | Electrocardiogram ambulatory abnormal | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| HCVO | Ventricular extrasystoles | · | · | ✓ |
| SD | Back pain | · | · | ✓ |
| SD | Bone pain | · | · | ✓ |
| SD | Cardiac disorder | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Dysuria | · | · | ✓ |
| SD | Heart rate increased | · | · | ✓ |
| SD | Hypoaesthesia | · | · | ✓ |
| SD | Myalgia | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Neck pain | · | · | ✓ |
| SD | Neuralgia | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SD | Urine output decreased | · | · | ✓ |
| SRO | Abdominal pain upper | ✓ | ✓ | ✓ |
| SRO | Aspiration | ✓ | ✓ | ✓ |
| SRO | Flatulence | ✓ | ✓ | ✓ |
| SRO | Retching | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release