6HL-96717-96971
4 vaccinations
5 coded responses
25 check-ins
5 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 327 / FL
- Registered
- 2021-01-30
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-28
Dose 1 — Moderna
-
2021-01-30
Registered in v-safe
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2021-01-30
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-01-31
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-11
- 2021-02-18
-
2021-02-25
Dose 2 — Moderna
- 2021-02-25
-
2021-02-26
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-28
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Headache, Muscle or body achesAdult check-in
- 2021-03-01
- 2021-03-02
- 2021-03-03
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2021-03-04
Survey response — day 7, dose 2MedDRA: Dizziness, Influenza like illness — Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesFree text: Feeling like the flu. Been in bed most of day. DizzyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-04-01
- 2021-04-08
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2021-05-27
Survey response — 3 months, dose 2MedDRA: Fatigue, Liver function test increased, Nephrolithiasis, Office visit, Vocal cord dysfunction — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Bladder and urithal stones. Liver function test real high and vocal cords wont close all the way. Extremely tired · Healthcare visit (other): Gastroenterologist, ENT, and Euro gynecologist.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-27
Report sent to call center — 3 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
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2021-08-16
Dose 3 — Moderna
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2021-08-26
Survey response — 6 months, dose 2MedDRA: Malaise — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: I because extremely sick after that booster shot.MedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-26
Report sent to call center — 6 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-27
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2021-11-15
Survey response — 3 months, dose 3MedDRA: Hospitalisation, Malaise, Pneumonia — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: Pneumonia in the hospital. Was very sick after my booster shot.MedDRA releases: 2024-11 · check-in free text available
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2021-11-15
Report sent to call center — 3 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2021-11-16
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2022-01-17
Dose 4 — Moderna
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2022-02-14
Survey response — 6 months, dose 3MedDRA: Abdominal pain upper, Office visit — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Extreme screaming pain in upper stomach under breast. Endoscopy already done just waiting for MRI to get done. · Healthcare visit (other): PcMedDRA releases: 2024-11 · check-in free text available
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2022-02-14
Report sent to call center — 6 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-02-15
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-28 | Moderna | |
| 2 | 2021-02-25 | Moderna | |
| 3 | 2021-08-16 | Moderna | No |
| 4 | 2022-01-17 | Moderna | No |
Call center
4 call center cases
4 successful
Free text
Release 5 — day 7, dose 2
Systemic reaction (other): Feeling like the flu. Been in bed most of day. Dizzy
Release 8 — 3 months, dose 2
Symptoms: Bladder and urithal stones. Liver function test real high and vocal cords wont close all the way. Extremely tired
Healthcare visit (other): Gastroenterologist, ENT, and Euro gynecologist.
Release 9 — 6 months, dose 2
Symptoms: I because extremely sick after that booster shot.
Release 10 — 3 months, dose 3
Symptoms: Pneumonia in the hospital. Was very sick after my booster shot.
Release 11 — 6 months, dose 3
Symptoms: Extreme screaming pain in upper stomach under breast. Endoscopy already done just waiting for MRI to get done.
Healthcare visit (other): Pc
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 | Abdominal pain upper | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Hospitalisation | · | · | ✓ |
| SD | Liver function test increased | ✓ | ✓ | ✓ |
| SD | Malaise | ✓ | · | ✓ |
| SD | Nephrolithiasis | ✓ | ✓ | ✓ |
| SD | Pneumonia | · | · | ✓ |
| SD | Vocal cord dysfunction | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Influenza like illness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release