6BF-14181-17059
5 vaccinations
10 coded responses
60 check-ins
9 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 126 / NY
- Registered
- 2021-03-19
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Registered dependents
4NM-19879-07405
Adult relative or friend · Female · 2021-12-14
EX2-30573-09637
Adult relative or friend · Female · 2022-09-12
Timeline
-
2021-03-17
Dose 1 — Moderna
-
2021-03-19
Registered in v-safe
- 2021-03-19
- 2021-03-20
- 2021-03-21
- 2021-03-23
- 2021-03-24
- 2021-03-31
- 2021-04-07
-
2021-04-14
Dose 2 — Moderna
- 2021-04-14
- 2021-04-15
- 2021-04-16
- 2021-04-17
- 2021-04-18
-
2021-04-19
Survey response — days 1–6 daily, dose 2MedDRA: Injection site erythema, Injection site pain, Injection site pruritus, Injection site rash, Rash macular — Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection siteFree text: The rash is a red blotch, sore, yet slightly itchy and about 5 or so inches below the injection site.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-21
Health check-in — day 7, dose 2Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-04-28
- 2021-05-05
- 2021-05-12
- 2021-05-21
- 2021-05-26
- 2021-07-15
-
2021-09-01
Dose 3 — Moderna
-
2021-09-02
Survey response — days 1–6 daily, dose 3MedDRA: Swelling, Tenderness — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Fatigue or tirednessFree text: Slight swollen, sore bump on my collarbone on the side of the injection. Mostly sore to the touch.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-09-03
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tirednessAdult check-in
-
2021-09-04
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Swelling, Itching · NoneAdult check-in
-
2021-09-05
Survey response — days 1–6 daily, dose 3MedDRA: Erythema, Neck mass, Peripheral swelling, Tenderness — Feeling: Good · Site: ItchingFree text: Theres a small raised & red spot on my inside forearm. Its sore to the touch. The lump on my collarbone that is sore to the touch getting smaller. All are on the side of the arm where I got the shot.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-09-06
Survey response — days 1–6 daily, dose 3MedDRA: Neck mass — Feeling: Good · Site: ItchingFree text: The raised area (lump) in my collarbone area is still there but its smaller than yesterday and less sore.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-09-08
Survey response — day 7, dose 3MedDRA: Neck mass — Feeling: GoodFree text: The lump near my collarbone is almost gone.MedDRA releases: 2024-11 · check-in free text available
-
2021-09-15
Survey response — day 14, dose 3MedDRA: Diarrhoea — Feeling: GoodFree text: DiarrheaMedDRA releases: 2024-11 · check-in free text available
- 2021-09-22
- 2021-09-29
- 2021-10-06
- 2021-10-13
- 2021-12-01
- 2022-03-03
-
2022-03-22
Dose 4 — Moderna
-
2022-03-23
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2022-03-24
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
-
2022-03-25
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Swelling · Joint painsAdult check-in
-
2022-03-26
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Swelling · Muscle or body achesAdult check-in
- 2022-03-27
- 2022-03-28
- 2022-03-29
- 2022-04-05
-
2022-04-12
Survey response — day 21, dose 4MedDRA: Eye pain, Ocular hyperaemia — Feeling: GoodFree text: Right eye pain & redness on same side where 2nd booster vaccine was given (other eye is fine).MedDRA releases: 2024-11 · check-in free text available
- 2022-04-19
- 2022-04-26
- 2022-05-03
-
2022-06-21
Survey response — 3 months, dose 4MedDRA: Atrial fibrillation, Hypertonic bladder, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: AFib, Overactive Bladder · Healthcare visit (other): Office visitMedDRA releases: 2024-11 · check-in free text available
-
2022-06-21
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professional1 call case(s)
- 2022-06-22
-
2022-07-07
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-09-11
Dose 5 — Moderna
-
2022-09-12
Survey response — days 1–6 daily, dose 5MedDRA: Rhinorrhoea — Feeling: Good · Site: PainFree text: Slightly runny nose (very minimal).MedDRA releases: 2024-11 · check-in free text available
-
2022-09-13
Health check-in — days 1–6 daily, dose 5Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-09-14
- 2022-09-15
- 2022-09-16
- 2022-09-17
- 2022-09-18
- 2022-09-25
- 2022-10-02
- 2022-10-09
- 2022-10-16
- 2022-10-24
- 2022-12-11
-
2023-03-12
Survey response — 6 months, dose 5MedDRA: Atrial fibrillation, Pre-existing disease, Red blood cell count decreased, Systemic lupus erythematosus — Feeling: Fair · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-17 | Moderna | |
| 2 | 2021-04-14 | Moderna | |
| 3 | 2021-09-01 | Moderna | No |
| 4 | 2022-03-22 | Moderna | No |
| 5 | 2022-09-11 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): The rash is a red blotch, sore, yet slightly itchy and about 5 or so inches below the injection site.
Release 9 — days 1–6 daily, dose 3
Systemic reaction (other): Slight swollen, sore bump on my collarbone on the side of the injection. Mostly sore to the touch.
Systemic reaction (other): Theres a small raised & red spot on my inside forearm. Its sore to the touch. The lump on my collarbone that is sore to the touch getting smaller. All are on the side of the arm where I got the shot.
Systemic reaction (other): The raised area (lump) in my collarbone area is still there but its smaller than yesterday and less sore.
Release 9 — day 7, dose 3
Systemic reaction (other): The lump near my collarbone is almost gone.
Release 9 — day 14, dose 3
Symptoms: Diarrhea
Release 11 — day 21, dose 4
Symptoms: Right eye pain & redness on same side where 2nd booster vaccine was given (other eye is fine).
Release 12 — 3 months, dose 4
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): Slightly runny nose (very minimal).
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 | Office visit | · | · | ✓ |
| SD | Atrial fibrillation | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Eye pain | · | · | ✓ |
| SD | Hypertonic bladder | · | · | ✓ |
| SD | Ocular hyperaemia | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Red blood cell count decreased | · | · | ✓ |
| SD | Systemic lupus erythematosus | · | · | ✓ |
| SRO | Erythema | ✓ | · | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site pruritus | ✓ | ✓ | ✓ |
| SRO | Injection site rash | ✓ | ✓ | ✓ |
| SRO | Neck mass | ✓ | · | ✓ |
| SRO | Peripheral swelling | ✓ | · | ✓ |
| SRO | Rash macular | ✓ | ✓ | ✓ |
| SRO | Rhinorrhoea | · | · | ✓ |
| SRO | Swelling | ✓ | · | ✓ |
| SRO | Tenderness | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release