6DH-17987-95629
5 vaccinations
10 coded responses
50 check-ins
10 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 122 / NY
- Registered
- 2021-02-25
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-25
Registered in v-safe
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2021-02-25
Dose 1 — Moderna
- 2021-02-25
- 2021-02-26
- 2021-02-27
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2021-02-28
Survey response — days 1–6 daily, dose 1MedDRA: Epistaxis, Respiratory tract congestion — Feeling: GoodFree text: Some congestion. A couple of nose bleedsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-01
Survey response — days 1–6 daily, dose 1MedDRA: Feeling abnormal — Feeling: Fair · Joint pains, Muscle or body achesFree text: Just feel off center as it wereMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-02
Survey response — days 1–6 daily, dose 1MedDRA: Feeling abnormal — Feeling: Fair · Chills, Headache, Fatigue or tirednessFree text: Still feel slightly out of kilter.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-03
- 2021-03-04
- 2021-03-11
- 2021-03-18
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2021-03-25
Dose 2 — Moderna
- 2021-03-25
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2021-03-26
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-03-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tirednessAdult check-in
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2021-03-28
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body achesAdult check-in
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2021-03-29
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Chills, Headache, Joint pains, Muscle or body achesAdult check-in
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2021-03-30
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-03-31
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Chills, Headache, Joint pains, Muscle or body achesAdult check-in
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2021-04-01
Health check-in — day 7, dose 2Feeling: Fair · Chills, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-08
- 2021-04-15
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2021-04-22
Survey response — day 28, dose 2MedDRA: Epistaxis, Respiratory tract congestion, Throat irritation — Feeling: FairFree text: Increased congestion. Occasional scratchy throat. Nosebleeds.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-29
- 2021-05-06
- 2021-06-24
- 2021-09-23
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2021-10-22
Dose 3 — Moderna
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2021-10-29
Health check-in — day 7, dose 3Feeling: Fair · Chills, Headache, Muscle or body achesAdult check-in
- 2021-11-05
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2021-11-12
Survey response — day 21, dose 3MedDRA: Herpes zoster — Feeling: FairFree text: A case of shinglesMedDRA releases: 2024-11 · check-in free text available
- 2021-11-19
- 2021-11-26
- 2021-12-03
- 2022-01-21
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2022-04-14
Dose 4 — Moderna
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2022-04-18
Survey response — days 1–6 daily, dose 4MedDRA: Epistaxis, Respiratory tract congestion — Feeling: Fair · Site: Pain, Itching · Chills, Joint pains, Muscle or body aches, Fatigue or tirednessFree text: Congestion and nose bleedsMedDRA releases: 2024-11 · check-in free text available
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2022-04-19
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Itching · Fatigue or tirednessAdult check-in
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2022-04-20
Survey response — days 1–6 daily, dose 4MedDRA: Epistaxis, Respiratory tract congestion — Feeling: Fair · Chills, Headache, Fatigue or tirednessFree text: Congestion/nose bleedMedDRA releases: 2024-11 · check-in free text available
- 2022-04-21
- 2022-04-28
- 2022-05-05
- 2022-05-12
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2022-05-19
Survey response — day 35, dose 4MedDRA: Cough, Eye pruritus, Herpes zoster, Lacrimation increased, Respiratory tract congestion — Feeling: FairFree text: Shingles. Cough. Congestion. Itchy watery eyes.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-26
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2022-07-14
Survey response — 3 months, dose 4MedDRA: Cough, Night sweats, Respiratory tract congestion, Sneezing — Feeling: FairFree text: Congestion, night sweats, sneezing and coughing . I took 2 home tests since Saturday. Both were negative. I am retiredMedDRA releases: 2024-11 · check-in free text available
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2022-09-13
Dose 5 — Moderna
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2022-09-22
Survey response — day 7, dose 5MedDRA: Respiratory tract congestion — Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Fatigue or tirednessFree text: CongestionMedDRA releases: 2024-11 · check-in free text available
- 2022-09-27
- 2022-10-04
- 2022-10-11
- 2022-10-18
- 2022-10-25
- 2022-12-13
- 2023-03-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-25 | Moderna | |
| 2 | 2021-03-25 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
| 4 | 2022-04-14 | Moderna | No |
| 5 | 2022-09-13 | Moderna | No |
Free text
Release 4 — days 1–6 daily, dose 1
Systemic reaction (other): Some congestion. A couple of nose bleeds
Systemic reaction (other): Just feel off center as it were
Systemic reaction (other): Still feel slightly out of kilter.
Release 7 — day 28, dose 2
Symptoms: Increased congestion. Occasional scratchy throat. Nosebleeds.
Release 10 — day 21, dose 3
Symptoms: A case of shingles
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Congestion and nose bleeds
Systemic reaction (other): Congestion/nose bleed
Release 11 — day 35, dose 4
Symptoms: Shingles. Cough. Congestion. Itchy watery eyes.
Release 12 — 3 months, dose 4
Symptoms: Congestion, night sweats, sneezing and coughing . I took 2 home tests since Saturday. Both were negative. I am retired
Release 12 — day 7, dose 5
Systemic reaction (other): Congestion
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 | Epistaxis | ✓ | ✓ | ✓ |
| SD | Eye pruritus | · | · | ✓ |
| SD | Herpes zoster | · | · | ✓ |
| SD | Lacrimation increased | · | · | ✓ |
| SD | Night sweats | · | · | ✓ |
| SD | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SD | Sneezing | · | · | ✓ |
| SD | Throat irritation | ✓ | ✓ | ✓ |
| SRO | Epistaxis | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Respiratory tract congestion | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release