6N6-17162-77967
2 vaccinations
3 coded responses
18 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 451 / OH
- Registered
- 2020-12-28
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-28
Registered in v-safe
-
2020-12-28
Dose 1 — Moderna
-
2020-12-28
Survey response — day 0, dose 1MedDRA: Pain, Pain in extremity — Feeling: Good · Site: PainFree text: Hurts to lift arm, so more than mild pain I feel but I can still workMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2020-12-29
- 2020-12-30
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-05
- 2021-01-11
- 2021-01-18
- 2021-01-25
-
2021-01-26
Dose 2 — Moderna
-
2021-02-01
Survey response — days 1–6 daily, dose 2MedDRA: Asthenia, Chills, Feeling abnormal, Headache, Injection site pain, Pain, Pyrexia — Feeling: GoodFree text: 12 hours after the 2nd vaccine I felt horrible. 101.8 fever body aches, chills , headache, weak, bad arm pain in arm where I got injection. All these symptoms lasted about 40 hoursMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-02
-
2021-02-23
Survey response — day 28, dose 2MedDRA: Nephrolithiasis, Office visit, Urinary tract infection — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: UTI symptoms, more likely a kidney stone that possibly passed as I had a clot in urine and hip pain. I have never had any kidney stone issues prior · Healthcare visit (other): Made an appt to see my physicianMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-23
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-02
- 2021-03-11
- 2021-04-27
- 2021-07-27
- 2021-08-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Moderna | |
| 2 | 2021-01-26 | Moderna |
Call center
1 call center case
1 unsuccessful
1 wait over 3 months for a first call
Free text
Release 1 — day 0, dose 1
Systemic reaction (other): Hurts to lift arm, so more than mild pain I feel but I can still work
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): 12 hours after the 2nd vaccine I felt horrible. 101.8 fever body aches, chills , headache, weak, bad arm pain in arm where I got injection. All these symptoms lasted about 40 hours
Release 4 — day 28, dose 2
Symptoms: UTI symptoms, more likely a kidney stone that possibly passed as I had a clot in urine and hip pain. I have never had any kidney stone issues prior
Healthcare visit (other): Made an appt to see my 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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SD | Nephrolithiasis | ✓ | ✓ | ✓ |
| SD | Urinary tract infection | ✓ | ✓ | ✓ |
| SRO | Asthenia | ✓ | ✓ | ✓ |
| SRO | Axillary pain | ○ | ○ | ○ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Impaired work ability | ○ | ○ | ○ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release