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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

  1. 2021-02-10
    Dose 1 — Moderna
  2. 2021-03-09
    Dose 2 — Moderna
  3. 2021-11-10
    Registered in v-safe
  4. 2021-11-10
    Dose 3 — Pfizer-BioNTech
  5. 2021-11-11
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  6. 2021-11-13
    Survey response — days 1–6 daily, dose 3
    MedDRA: Back pain, Nausea — Feeling: Fair · Site: Itching · Muscle or body aches, Nausea · Be unable to do your normal daily activities
    Free 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
  7. 2021-11-14
    Survey response — days 1–6 daily, dose 3
    MedDRA: Back disorder, Oral herpes — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities
    Free 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
  8. 2021-11-15
    Survey response — days 1–6 daily, dose 3
    MedDRA: Back pain, Oral herpes — Feeling: Good · Muscle or body aches
    Free text: Cold sore, back ache.
    MedDRA releases: 2024-11 · check-in free text available
  9. 2021-11-17
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  10. 2021-11-24
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  11. 2021-12-01
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  12. 2021-12-08
    Survey response — day 28, dose 3
    MedDRA: Back pain — Feeling: Good
    Free text: Continuing backache.
    MedDRA releases: 2024-11 · check-in free text available
  13. 2021-12-17
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  14. 2021-12-24
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  15. 2022-02-09
    Survey response — 3 months, dose 3
    MedDRA: Injection site pruritus — Feeling: Good
    Free 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
  16. 2022-04-18
    Dose 4 — Pfizer-BioNTech
  17. 2022-04-18
    Health check-in — day 0, dose 4
    Feeling: Good · None
    Adult check-in
  18. 2022-04-19
    Survey response — days 1–6 daily, dose 4
    MedDRA: 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 activities
    Free text: Ears ringing
    MedDRA releases: 2024-11 · check-in free text available
  19. 2022-04-20
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Headache, Fatigue or tiredness
    Adult check-in
  20. 2022-04-21
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  21. 2022-04-22
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  22. 2022-04-24
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  23. 2022-04-27
    Health check-in — day 7, dose 4
    Feeling: Good · None
    Adult check-in
  24. 2022-05-02
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  25. 2022-05-09
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  26. 2022-05-16
    Survey response — day 28, dose 4
    MedDRA: Fatigue, Rhinorrhoea — Feeling: Good
    Free text: Slightly runny nose and slight fatigue for 2 days. Okay now.
    MedDRA releases: 2024-11 · check-in free text available
  27. 2022-05-23
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  28. 2022-06-01
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  29. 2022-07-20
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  30. 2023-04-18
    Health check-in — 12 months, dose 4
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-10Moderna No
22021-03-09Moderna No
32021-11-10Pfizer-BioNTech No
42022-04-18Pfizer-BioNTech No

Free text

Release 10 — days 1–6 daily, dose 3

2021-11-13

Systemic reaction (other): Nausea may not have been related to vaccine, but to intense lower back pain yesterday.Still have some back pain today.

2021-11-14

Systemic reaction (other): My back is healing, but I have a cold sore and need to be quiet today.

2021-11-15

Systemic reaction (other): Cold sore, back ache.

Release 10 — day 28, dose 3

2021-12-08

Symptoms: Continuing backache.

Release 11 — 3 months, dose 3

2022-02-09

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

2022-04-19

Systemic reaction (other): Ears ringing

Release 11 — day 28, dose 4

2022-05-16

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

FieldPreferred term2021-092023-042024-11
SDBack pain · · ✓
SDFatigue · · ✓
SDInjection site pruritus · · ✓
SDRhinorrhoea · · ✓
SROBack disorder · · ✓
SROBack pain · · ✓
SRONausea · · ✓
SROOral herpes · · ✓
SROTinnitus · · ✓

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