6R5-12349-56764
5 vaccinations
4 coded responses
25 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 373 / TN
- Registered
- 2021-01-07
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-30
Dose 1 — Moderna
-
2021-01-07
Registered in v-safe
- 2021-01-07
- 2021-01-13
- 2021-01-21
-
2021-01-28
Dose 2 — Moderna
- 2021-01-30
- 2021-01-31
- 2021-02-03
- 2021-02-04
- 2021-02-11
- 2021-02-25
- 2021-03-05
- 2021-03-13
- 2021-05-02
- 2021-07-29
-
2021-08-20
Dose 3 — Moderna
-
2021-11-19
Survey response — 3 months, dose 3MedDRA: Angiogram, Intracranial aneurysm — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: 3 brain aneurysms identified by CTAMedDRA releases: 2024-11 · check-in free text available
-
2021-11-19
Report sent to call center — 3 months, dose 3Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2021-11-30
- 2021-12-03
- 2021-12-03
-
2022-02-18
Survey response — 6 months, dose 3MedDRA: Epistaxis — Feeling: GoodFree text: Left nostril Nosebleeds about very 3-4 days for the past monthMedDRA releases: 2024-11 · check-in free text available
-
2022-04-03
Dose 4 — Moderna
- 2022-04-14
- 2022-04-17
- 2022-04-24
- 2022-05-01
- 2022-05-10
- 2022-05-15
-
2022-07-03
Survey response — 3 months, dose 4MedDRA: Cerebrovascular accident, Dizziness, Emergency care, Nausea, Post procedural complication, SARS-CoV-2 test negative, Vomiting — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Lightheaded, nausea, vomiting on 7/2/22. We to Emergency Dept @ (b)(6) Hospital. Tested NEGATIVE for COVID, stroke, and adverse incident related to brain angiogram performed 7 days prior.MedDRA releases: 2024-11 · check-in free text available
-
2022-07-03
Report sent to call center — 3 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
-
2022-07-06
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-10-02
Survey response — 6 months, dose 4MedDRA: Nasal congestion, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test positive — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Sore throat began 9/17, nasal & chest congestion ensued. Tested + for COVID on 9/ 19 using an at home antigen test. Chest & nasal congestion with + COVID test results continued until 9/ 29. 9/30 symptoms improved & I got a NEGATIVE test result.MedDRA releases: 2024-11 · check-in free text available
-
2022-10-02
Report sent to call center — 6 months, dose 4Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-10-03
-
2022-11-26
Dose 5 — Moderna
- 2023-04-05
- 2023-05-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-30 | Moderna | |
| 2 | 2021-01-28 | Moderna | |
| 3 | 2021-08-20 | Moderna | No |
| 4 | 2022-04-03 | Moderna | No |
| 5 | 2022-11-26 | Moderna | No |
Call center
3 call center cases
2 successful · 1 unsuccessful
Free text
Release 10 — 3 months, dose 3
Symptoms: 3 brain aneurysms identified by CTA
Release 11 — 6 months, dose 3
Symptoms: Left nostril Nosebleeds about very 3-4 days for the past month
Release 12 — 3 months, dose 4
Symptoms: Lightheaded, nausea, vomiting on 7/2/22. We to Emergency Dept @ (b)(6) Hospital. Tested NEGATIVE for COVID, stroke, and adverse incident related to brain angiogram performed 7 days prior.
redacted (b)(6)
Release 12 — 6 months, dose 4
Symptoms: Sore throat began 9/17, nasal & chest congestion ensued. Tested + for COVID on 9/ 19 using an at home antigen test. Chest & nasal congestion with + COVID test results continued until 9/ 29. 9/30 symptoms improved & I got a NEGATIVE test result.
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 | Angiogram | · | · | ✓ |
| SD | Cerebrovascular accident | · | · | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Emergency care | · | · | ✓ |
| SD | Epistaxis | · | · | ✓ |
| SD | Intracranial aneurysm | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Post procedural complication | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Vomiting | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release