6DH-22134-61338
3 vaccinations
3 coded responses
41 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 860 / AZ
- Registered
- 2021-02-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-03
Registered in v-safe
-
2021-02-03
Dose 1 — Moderna
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-10
- 2021-02-17
- 2021-02-24
-
2021-03-03
Dose 2 — Moderna
- 2021-03-03
-
2021-03-04
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
-
2021-03-17
Survey response — day 14, dose 2MedDRA: Rash, Urticaria — Feeling: GoodFree text: I had bumps, like hives, in random places... arms, face, chest. About 10 total that appeared about six days after my shot. Im not sure if it was related or coincidental.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-24
-
2021-03-31
Survey response — day 28, dose 2MedDRA: Rash — Feeling: GoodFree text: I said this a few weeks ago and not at all sure if its related to the vaccine, but Ive had some sporadic hive-like bumps on my face, neck, and arms. Just thought Id mention it in case others have experienced the same thing.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-07
- 2021-04-14
- 2021-06-04
- 2021-09-01
-
2021-11-30
Dose 3 — ModernaCo-administered: Flu
- 2021-11-30
-
2021-12-01
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-12-02
- 2021-12-03
- 2021-12-04
- 2021-12-05
- 2021-12-06
- 2021-12-07
- 2021-12-14
- 2021-12-21
-
2021-12-28
Survey response — day 28, dose 3MedDRA: Cough, Pain, Pyrexia, Respiratory tract congestion, Unevaluable event — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: I think I might have Covid. I have congestion, body aches, a tickling cough, and low grade fever. · Healthcare visit (other): I had a physical therapy appt scheduled and I canceled it.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-28
Report sent to call center — day 28, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2021-12-30
- 2022-01-04
- 2022-01-11
- 2022-03-01
- 2022-05-31
- 2022-12-01
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-03 | Moderna | |
| 2 | 2021-03-03 | Moderna | |
| 3 | 2021-11-30 | Moderna | Flu |
Call center
1 call center case
1 unsuccessful
Free text
Release 5 — day 14, dose 2
Symptoms: I had bumps, like hives, in random places... arms, face, chest. About 10 total that appeared about six days after my shot. Im not sure if it was related or coincidental.
Release 6 — day 28, dose 2
Symptoms: I said this a few weeks ago and not at all sure if its related to the vaccine, but Ive had some sporadic hive-like bumps on my face, neck, and arms. Just thought Id mention it in case others have experienced the same thing.
Release 10 — day 28, dose 3
Symptoms: I think I might have Covid. I have congestion, body aches, a tickling cough, and low grade fever.
Healthcare visit (other): I had a physical therapy appt scheduled and I canceled it.
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 | Cough | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Urticaria | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release