6HT-11890-50257
4 vaccinations
7 coded responses
25 check-ins
7 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 531 / WI
- Registered
- 2021-11-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-10
Dose 1 — Moderna
-
2021-03-09
Dose 2 — Moderna
-
2021-11-10
Registered in v-safe
-
2021-11-10
Dose 3 — Pfizer-BioNTech
-
2021-11-11
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-11-13
Survey response — days 1–6 daily, dose 3MedDRA: Back pain, Nausea — Feeling: Fair · Site: Itching · Muscle or body aches, Nausea · Be unable to do your normal daily activitiesFree text: Nausea may not have been related to vaccine, but to intense lower back pain yesterday.Still have some back pain today.MedDRA releases: 2024-11 · check-in free text available
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2021-11-14
Survey response — days 1–6 daily, dose 3MedDRA: Back disorder, Oral herpes — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: My back is healing, but I have a cold sore and need to be quiet today.MedDRA releases: 2024-11 · check-in free text available
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2021-11-15
Survey response — days 1–6 daily, dose 3MedDRA: Back pain, Oral herpes — Feeling: Good · Muscle or body achesFree text: Cold sore, back ache.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-17
- 2021-11-24
- 2021-12-01
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2021-12-08
Survey response — day 28, dose 3MedDRA: Back pain — Feeling: GoodFree text: Continuing backache.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-17
- 2021-12-24
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2022-02-09
Survey response — 3 months, dose 3MedDRA: Injection site pruritus — Feeling: GoodFree text: Slightly itchy at sight of injection this morning. Did not last. Momentary two times. Did not occur previously.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-18
Dose 4 — Pfizer-BioNTech
- 2022-04-18
-
2022-04-19
Survey response — days 1–6 daily, dose 4MedDRA: Tinnitus — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Ears ringingMedDRA releases: 2024-11 · check-in free text available
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2022-04-20
Health check-in — days 1–6 daily, dose 4Feeling: Good · Headache, Fatigue or tirednessAdult check-in
- 2022-04-21
- 2022-04-22
- 2022-04-24
- 2022-04-27
- 2022-05-02
- 2022-05-09
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2022-05-16
Survey response — day 28, dose 4MedDRA: Fatigue, Rhinorrhoea — Feeling: GoodFree text: Slightly runny nose and slight fatigue for 2 days. Okay now.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-23
- 2022-06-01
- 2022-07-20
- 2023-04-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-10 | Moderna | No |
| 2 | 2021-03-09 | Moderna | No |
| 3 | 2021-11-10 | Pfizer-BioNTech | No |
| 4 | 2022-04-18 | Pfizer-BioNTech | No |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Nausea may not have been related to vaccine, but to intense lower back pain yesterday.Still have some back pain today.
Systemic reaction (other): My back is healing, but I have a cold sore and need to be quiet today.
Systemic reaction (other): Cold sore, back ache.
Release 10 — day 28, dose 3
Symptoms: Continuing backache.
Release 11 — 3 months, dose 3
Symptoms: Slightly itchy at sight of injection this morning. Did not last. Momentary two times. Did not occur previously.
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): Ears ringing
Release 11 — day 28, dose 4
Symptoms: Slightly runny nose and slight fatigue for 2 days. Okay now.
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 | Back pain | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Injection site pruritus | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SRO | Back disorder | · | · | ✓ |
| SRO | Back pain | · | · | ✓ |
| SRO | Nausea | · | · | ✓ |
| SRO | Oral herpes | · | · | ✓ |
| SRO | Tinnitus | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release