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6JX-16938-93585

2 vaccinations 4 coded responses 25 check-ins 4 free-text entries 1 call case
Sex
Female
Age at first dose
51-55
ZIP prefix
795 / TX
Registered
2021-07-17
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-07-16
    Dose 1 — Moderna
  2. 2021-07-17
    Registered in v-safe
  3. 2021-07-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site
    Adult check-in
  4. 2021-07-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  5. 2021-07-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Headache, Fatigue or tiredness
    Adult check-in
  6. 2021-07-20
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  7. 2021-07-21
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  8. 2021-07-22
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  9. 2021-07-23
    Health check-in — day 7, dose 1
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  10. 2021-07-30
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-08-06
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-08-13
    Dose 2 — Moderna
  13. 2021-08-13
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  14. 2021-08-14
    Survey response — days 1–6 daily, dose 2
    MedDRA: Blood glucose increased, Diabetes mellitus, Pre-existing disease — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: Type 1 diabetic - sugars have been high today - have only eaten toast
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  15. 2021-08-15
    Survey response — days 1–6 daily, dose 2
    MedDRA: Blood glucose increased, Chills, Headache, Night sweats, Pain, Pyrexia, Sensitive skin — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness
    Free text: Yesterday - late afternoon and night was really bad - I was running a low grade fever - chills - headache - body aches - sensitive skin and hi blood sugars - around 11 pm I woke up in a sweat - my fever had broke and my sugars returned to normal
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  16. 2021-08-16
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Headache, Fatigue or tiredness
    Adult check-in
  17. 2021-08-17
    Survey response — days 1–6 daily, dose 2
    MedDRA: Blood glucose increased — Feeling: Fair · Headache, Fatigue or tiredness
    Free text: Have had hi blood sugars for 3 straight days - couldnt get them down - finally are better today!
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  18. 2021-08-18
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Headache
    Adult check-in
  19. 2021-08-19
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Fatigue or tiredness, Abdominal pain
    Adult check-in
  20. 2021-08-20
    Health check-in — day 7, dose 2
    Feeling: Fair · Headache, Fatigue or tiredness
    Adult check-in
  21. 2021-08-27
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-09-03
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-09-10
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-09-17
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-09-24
    Survey response — day 42, dose 2
    MedDRA: Office visit, Peripheral arterial occlusive disease — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Found out, In the last month, I have plaque build up in my lower extremities. · Healthcare visit (other): Office visit with my primary care physician
    MedDRA releases: 2024-11 · check-in free text available
  26. 2021-09-24
    Report sent to call center — day 42, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  27. 2021-09-28
  28. 2021-10-06
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  29. 2021-11-12
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  30. 2022-02-11
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  31. 2022-08-13
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-07-16Moderna No
22021-08-13Moderna No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 9 — days 1–6 daily, dose 2

2021-08-14

Systemic reaction (other): Type 1 diabetic - sugars have been high today - have only eaten toast

2021-08-15

Systemic reaction (other): Yesterday - late afternoon and night was really bad - I was running a low grade fever - chills - headache - body aches - sensitive skin and hi blood sugars - around 11 pm I woke up in a sweat - my fever had broke and my sugars returned to normal

2021-08-17

Systemic reaction (other): Have had hi blood sugars for 3 straight days - couldnt get them down - finally are better today!

Release 9 — day 42, dose 2

2021-09-24

Symptoms: Found out, In the last month, I have plaque build up in my lower extremities.
Healthcare visit (other): Office visit with my primary care physician

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
HCVOOffice visit · · ✓
SDPeripheral arterial occlusive disease · · ✓
SROBlood glucose increased ✓ · ✓
SROChills ✓ · ✓
SRODiabetes mellitus ✓ · ✓
SROHeadache ✓ · ✓
SRONight sweats ✓ · ✓
SROPain ✓ · ✓
SROPre-existing disease ✓ · ✓
SROPyrexia ✓ · ✓
SROSensitive skin ✓ · ✓
SROType 1 diabetes mellitus ○ · ○

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