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6GS-30290-09022

3 vaccinations 3 coded responses 22 check-ins 3 free-text entries 0 call cases
Sex
Female
Age at first dose
26-30
ZIP prefix
488 / MI
Registered
2021-04-23
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
5UL-33041-96027 Child or adolescent in my care · Male · 2022-06-21
AHT-14434-70520 Child or adolescent in my care · Female · 2022-06-21

Timeline

  1. 2021-03-25
    Dose 1 — Moderna
  2. 2021-04-22
    Dose 2 — Moderna
  3. 2021-04-23
    Registered in v-safe
  4. 2021-04-23
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Adult check-in
  5. 2021-04-24
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  6. 2021-04-25
    Survey response — days 1–6 daily, dose 2
    MedDRA: Axillary pain — Feeling: Good · Site: Redness
    Free text: Pain in armpit on the side of injection
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-04-26
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Nausea
    Adult check-in
  8. 2021-04-28
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  9. 2021-04-29
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  10. 2021-05-06
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  11. 2021-05-13
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-05-20
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-05-29
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-06-03
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-07-22
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-10-21
    Survey response — 6 months, dose 2
    MedDRA: Foetal death — Feeling: Good
    Free text: 12.5 week IUFD
    MedDRA releases: 2024-11 · check-in free text available
  17. 2021-10-23
    Dose 3 — Moderna
  18. 2021-10-30
    Health check-in — day 7, dose 3
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  19. 2021-11-06
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  20. 2021-11-13
    Health check-in — day 21, dose 3
    Feeling: Fair
    Adult check-in
  21. 2021-11-20
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  22. 2021-11-28
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  23. 2021-12-04
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  24. 2022-01-22
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  25. 2022-04-23
    Survey response — 6 months, dose 3
    MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: Poor
    Free text: Sore throat, congestion
    MedDRA releases: 2024-11 · check-in free text available
  26. 2022-10-23
    Health check-in — 12 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-25Moderna
22021-04-22Moderna
32021-10-23Moderna No

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-25

Systemic reaction (other): Pain in armpit on the side of injection

Release 10 — 6 months, dose 2

2021-10-21

Symptoms: 12.5 week IUFD

Release 11 — 6 months, dose 3

2022-04-23

Symptoms: Sore throat, 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

FieldPreferred term2021-092023-042024-11
SDFoetal death · · ✓
SDOropharyngeal pain · · ✓
SDRespiratory tract congestion · · ✓
SROAxillary pain ✓ ✓ ✓

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