6J4-11784-87069
1 vaccination
3 coded responses
10 check-ins
3 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 660 / KS
- Registered
- 2021-01-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-20
Registered in v-safe
-
2021-01-20
Dose 1 — Moderna
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2021-01-22
Survey response — days 1–6 daily, dose 1MedDRA: Chills, Headache, Pain — Feeling: Good · Site: Pain, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to workFree text: Yes- so the day after I didnt get to report for some reason and so I did a vac adverse as this was my second shot if I could fill out on Thursday I was in sever body aches slight chills and headache and then today it was all gone basicallyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-23
Survey response — days 1–6 daily, dose 1MedDRA: Headache, Impaired work ability, Pain — Feeling: Good · Site: Itching · Fatigue or tirednessFree text: Sorry I meant to put that I called in sick the day AFTEr my 2nd dose due to mod headache severe body achesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-24
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Swelling, Itching · NoneAdult check-in
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-02-03
- 2021-02-10
- 2021-07-21
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2022-01-20
Survey response — 12 months, dose 1MedDRA: SARS-CoV-2 test negative, Viral infection — Feeling: Poor · Be unable to work or attend schoolFree text: I got tested for covid was negative but got another little virus on boardMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-20 | Moderna |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Yes- so the day after I didnt get to report for some reason and so I did a vac adverse as this was my second shot if I could fill out on Thursday I was in sever body aches slight chills and headache and then today it was all gone basically
Systemic reaction (other): Sorry I meant to put that I called in sick the day AFTEr my 2nd dose due to mod headache severe body aches
Release 10 — 12 months, dose 1
Symptoms: I got tested for covid was negative but got another little virus on board
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 | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Impaired work ability | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release