6JK-33607-26044
4 vaccinations
4 coded responses
56 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 212 / MD
- Registered
- 2021-01-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-28
Registered in v-safe
-
2021-01-28
Dose 1 — Moderna
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-11
- 2021-02-18
- 2021-02-25
-
2021-02-26
Dose 2 — Moderna
- 2021-02-26
-
2021-02-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-28
Survey response — days 1–6 daily, dose 2MedDRA: Pain, Pyrexia, Self-medication — Feeling: Good · Site: PainFree text: Last night (after responding to your survey) my temperature went up to 101 and I felt achy all over. I took 2 Tylenol, slept well, and was fine this morning (temp 97).MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-01
Survey response — days 1–6 daily, dose 2MedDRA: Pre-existing disease — Feeling: Good · Site: PainFree text: I have a migraine, but its not related to the shot. I usually get a migraine each month around this time.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-02
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-04-02
- 2021-04-09
- 2021-05-28
- 2021-08-27
-
2021-10-27
Dose 3 — Moderna
- 2021-10-27
- 2021-10-28
-
2021-10-29
Survey response — days 1–6 daily, dose 3MedDRA: Dyschezia — Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Sharp pain when have bowel movementMedDRA releases: 2024-11 · check-in free text available
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-11
- 2021-11-17
- 2021-11-24
- 2021-12-01
- 2021-12-08
- 2022-01-26
-
2022-04-23
Dose 4 — Moderna
- 2022-04-23
- 2022-04-24
- 2022-04-25
- 2022-04-26
- 2022-04-27
- 2022-04-28
- 2022-04-29
- 2022-04-30
- 2022-05-07
- 2022-05-14
- 2022-05-21
-
2022-05-28
Survey response — day 35, dose 4MedDRA: Head discomfort, Office visit, Pain, Respiratory tract congestion, Sinusitis — 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: Congestion, pressure in head, general aches. No fever. Took two rapid tests that were negative. Went to Urgent Care and was told it's sinusitis. Got a PCR test at Urgent Care but no results yet.MedDRA releases: 2024-11 · check-in free text available
-
2022-05-28
Report sent to call center — day 35, dose 4Be 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)
-
2022-06-01
Call successfulNot applicable - Accidental Reporting
- 2022-06-04
- 2022-07-25
- 2022-10-22
- 2023-04-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-28 | Moderna | |
| 2 | 2021-02-26 | Moderna | |
| 3 | 2021-10-27 | Moderna | No |
| 4 | 2022-04-23 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Last night (after responding to your survey) my temperature went up to 101 and I felt achy all over. I took 2 Tylenol, slept well, and was fine this morning (temp 97).
Systemic reaction (other): I have a migraine, but its not related to the shot. I usually get a migraine each month around this time.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Sharp pain when have bowel movement
Release 11 — day 35, dose 4
Symptoms: Congestion, pressure in head, general aches. No fever. Took two rapid tests that were negative. Went to Urgent Care and was told it's sinusitis. Got a PCR test at Urgent Care but no results yet.
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 | Head discomfort | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SRO | Dyschezia | · | · | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release