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6FC-26706-45222

2 vaccinations 4 coded responses 15 check-ins 4 free-text entries 2 call cases
Sex
Female
Age at first dose
61-65
ZIP prefix
955 / CA
Registered
2021-02-13
Relationship
Self
Race
American Indian or Alaska Native
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-02-09
    Dose 1 — Moderna
  2. 2021-02-13
    Registered in v-safe
  3. 2021-02-15
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  4. 2021-02-16
    Health check-in — day 7, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  5. 2021-02-23
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  6. 2021-03-03
    Survey response — day 21, dose 1
    MedDRA: Injection site scab — Feeling: Good
    Free text: Nothing really, I know it can happen with injections; just noted at injection site a scab which wasn't there earlier. No pain, just that.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-03-08
    Dose 2 — Moderna
  8. 2021-03-08
    Health check-in — day 0, dose 2
    Feeling: Good · None
    Adult check-in
  9. 2021-03-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  10. 2021-03-11
    Survey response — days 1–6 daily, dose 2
    MedDRA: Fatigue, Pain in extremity — Feeling: Good · Fatigue or tiredness
    Free text: Day 2 arm pain & fatigue. That was it.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-03-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  12. 2021-03-14
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  13. 2021-03-15
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  14. 2021-03-22
    Survey response — day 14, dose 2
    MedDRA: Headache, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test, SARS-CoV-2 test negative, Throat irritation — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Symptoms: Sat. started with a tickle, then sore throat, slight HA. Sore throat cont through today, congestion. · Healthcare visit (other): Rapid test & PCR, check-up. Rapid negative..
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-03-22
    Report sent to call center — day 14, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  16. 2021-03-29
    Survey response — day 21, dose 2
    MedDRA: Chills, Cough, Fatigue, Influenza virus test negative, Oropharyngeal pain, SARS-CoV-2 test negative — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Sat- Wed. Sore throat, cough, chills, fatigue. COVID PCR Mon. Neg. Wed. As well as flu neg. Improved Wed.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-03-29
    Report sent to call center — day 21, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  18. 2021-04-06
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-04-19
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-06-07
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  21. 2022-01-12
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

DoseDateManufacturerCo-administered
12021-02-09Moderna
22021-03-08Moderna

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 5 — day 21, dose 1

2021-03-03

Symptoms: Nothing really, I know it can happen with injections; just noted at injection site a scab which wasn't there earlier. No pain, just that.

Release 5 — days 1–6 daily, dose 2

2021-03-11

Systemic reaction (other): Day 2 arm pain & fatigue. That was it.

Release 6 — day 14, dose 2

2021-03-22

Symptoms: Sat. started with a tickle, then sore throat, slight HA. Sore throat cont through today, congestion.
Healthcare visit (other): Rapid test & PCR, check-up. Rapid negative..

Release 6 — day 21, dose 2

2021-03-29

Symptoms: Sat- Wed. Sore throat, cough, chills, fatigue. COVID PCR Mon. Neg. Wed. As well as flu neg. Improved Wed.

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

FieldPreferred term2021-092023-042024-11
HCVOSARS-CoV-2 test ✓ ✓ ✓
HCVOSARS-CoV-2 test negative ✓ ✓ ✓
SDChills ✓ ✓ ✓
SDCough ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDInfluenza virus test negative ✓ ✓ ✓
SDInjection site scab ✓ ✓ ✓
SDOropharyngeal pain ✓ ✓ ✓
SDRespiratory tract congestion ✓ ✓ ✓
SDSARS-CoV-2 test negative ✓ ✓ ✓
SDThroat irritation ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release