6J5-13934-07996
4 vaccinations
6 coded responses
33 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 610 / IL
- Registered
- 2021-03-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-04
Registered in v-safe
-
2021-03-04
Dose 1 — Moderna
- 2021-03-04
-
2021-03-05
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tiredness, Abdominal painAdult check-in
-
2021-03-06
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-21
- 2021-03-25
-
2021-04-01
Dose 2 — Moderna
- 2021-04-01
-
2021-04-02
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-15
- 2021-04-22
- 2021-04-30
- 2021-05-08
- 2021-05-13
- 2021-07-01
-
2021-11-19
Dose 3 — Pfizer-BioNTech
-
2022-04-01
Survey response — 12 months, dose 2MedDRA: Acupuncture, Ageusia, Anosmia, Office visit, Paranasal sinus hypersecretion, Sputum discoloured — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Yellow Sinus drainage for about 2 months in December and January.Leaving me with new issues to deal with.How would I have any idea if this was or is related to side effects from the vaccine? Currently I am experiencing a loss of taste and smell. · Healthcare visit (other): ENT, then sought out Acupuncture which was the MOST beneficial of anything I tried. Western medicine seems to be expensive and counterproductive.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-01
Report sent to call center — 12 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2022-04-05
-
2022-10-20
Dose 4 — Pfizer-BioNTech
-
2022-10-28
Health check-in — day 7, dose 4Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
-
2022-11-03
Survey response — day 14, dose 4MedDRA: Diarrhoea, Nasal congestion — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Sporadic Diarrhea and nasal congestion. No stomach upset.MedDRA releases: 2024-11 · check-in free text available
- 2022-11-10
- 2022-11-17
-
2022-11-24
Survey response — day 35, dose 4MedDRA: Abdominal discomfort, Fatigue, Feeling abnormal, Nasal congestion, Throat irritation — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Congestion in nasal passages, tickly throat, feeling very tired, stomach upset and just not right.MedDRA releases: 2024-11 · check-in free text available
-
2022-12-01
Survey response — day 42, dose 4MedDRA: Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activitiesFree text: I have an overgrowth of yeast and stomach/intestinal issues. I deal with this periodically. It correlates with eating refined sugar. Might Other ingredients in vaccine help trigger this?MedDRA releases: 2024-11 · check-in free text available
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2023-01-19
Survey response — 3 months, dose 4MedDRA: Gastrointestinal disorder, Hypersensitivity, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
-
2023-04-22
Survey response — 6 months, dose 4MedDRA: Paranasal sinus hypersecretion, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-04 | Moderna | |
| 2 | 2021-04-01 | Moderna | |
| 3 | 2021-11-19 | Pfizer-BioNTech | No |
| 4 | 2022-10-20 | Pfizer-BioNTech | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 11 — 12 months, dose 2
Symptoms: Yellow Sinus drainage for about 2 months in December and January.Leaving me with new issues to deal with.How would I have any idea if this was or is related to side effects from the vaccine? Currently I am experiencing a loss of taste and smell.
Healthcare visit (other): ENT, then sought out Acupuncture which was the MOST beneficial of anything I tried. Western medicine seems to be expensive and counterproductive.
Release 12 — day 14, dose 4
Symptoms: Sporadic Diarrhea and nasal congestion. No stomach upset.
Release 12 — day 35, dose 4
Symptoms: Congestion in nasal passages, tickly throat, feeling very tired, stomach upset and just not right.
Release 12 — day 42, dose 4
Symptoms: I have an overgrowth of yeast and stomach/intestinal issues. I deal with this periodically. It correlates with eating refined sugar. Might Other ingredients in vaccine help trigger this?
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 | Acupuncture | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| SD | Abdominal discomfort | · | · | ✓ |
| SD | Ageusia | · | · | ✓ |
| SD | Anosmia | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Feeling abnormal | · | · | ✓ |
| SD | Gastrointestinal disorder | · | · | ✓ |
| SD | Hypersensitivity | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Paranasal sinus hypersecretion | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Sputum discoloured | · | · | ✓ |
| SD | Throat irritation | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release