6S7-17571-78641
5 vaccinations
10 coded responses
33 check-ins
10 free-text entries
5 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 957 / CA
- Registered
- 2021-02-24
- Relationship
- Self
- Race
- Other
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-26
Dose 1 — Moderna
-
2021-02-24
Registered in v-safe
- 2021-02-24
-
2021-02-26
Dose 2 — Moderna
-
2021-03-02
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling, Itching · Fatigue or tirednessAdult check-in
-
2021-03-03
Survey response — days 1–6 daily, dose 2MedDRA: No adverse event — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
- 2021-03-05
- 2021-03-14
- 2021-03-19
-
2021-03-26
Survey response — day 28, dose 2MedDRA: Cough, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Im having symptoms related to my asthma and am having at times severe coughing spells.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-26
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-09
- 2021-05-28
- 2021-08-27
-
2021-10-12
Dose 3 — Moderna
- 2022-01-19
- 2022-01-24
-
2022-02-28
Survey response — 12 months, dose 2MedDRA: Allergy to chemicals, Allergy to metals, Drug hypersensitivity — Feeling: GoodFree text: New allergies to many chemicals used in shampoo, wet wipes, lotion, body wash etc; as well as gold and some antibioticsMedDRA releases: 2024-11 · check-in free text available
-
2022-04-17
Dose 4 — Moderna
- 2022-04-26
- 2022-05-02
- 2022-05-13
- 2022-05-15
-
2022-05-23
Survey response — day 35, dose 4MedDRA: Incision site complication, Office visit, Pre-existing disease, Staphylococcal infection — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: I was just diagnosed with a staphylococcus infection at the end of a old abdominal incision. This was done 1977 or 1978. · Healthcare visit (other): Primary care physicianMedDRA releases: 2024-11 · check-in free text available
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2022-05-23
Report sent to call center — day 35, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-05-24
- 2022-05-24
-
2022-05-24
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-05-24
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-05-29
-
2022-07-19
Survey response — 3 months, dose 4MedDRA: Blood pressure increased, Debridement, Hypoaesthesia, Paraesthesia, Pelvic abscess, Surgery — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Symptoms: I had an episode where my blood pressure went a little bit higher than usual along with some numbness and tingling in my fingers and toes. I had a work up and everything was fine. I had an excision and debridement of suprapubic abscess · Healthcare visit (other): Outpatient surgeryMedDRA releases: 2024-11 · check-in free text available
-
2022-07-19
Report sent to call center — 3 months, dose 4Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
- 2022-07-20
- 2022-07-20
- 2022-07-20
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2022-07-25
Call successfulNot applicable - Accidental Reporting
-
2022-10-16
Survey response — 6 months, dose 4MedDRA: Diverticulitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visitFree text: Diagnosed with diverticulitisMedDRA releases: 2024-11 · check-in free text available
-
2022-10-16
Report sent to call center — 6 months, dose 4Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
-
2022-10-17
Call successfulNot applicable - Accidental Reporting
-
2022-10-20
Dose 5 — Moderna
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2022-10-20
Survey response — day 0, dose 5MedDRA: No adverse event — Feeling: Good · Site: Pain, SwellingFree text: NoMedDRA releases: 2024-11 · check-in free text available
-
2022-10-22
Survey response — days 1–6 daily, dose 5MedDRA: No adverse event — Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tirednessFree text: NoMedDRA releases: 2024-11 · check-in free text available
-
2022-10-24
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain, Swelling, Itching · Fatigue or tirednessAdult check-in
- 2022-10-25
- 2022-10-26
- 2022-10-27
- 2022-11-03
- 2022-11-10
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2022-11-19
Survey response — day 28, dose 5MedDRA: Hypersensitivity, Pre-existing disease, SARS-CoV-2 test negative — Feeling: FairFree text: My allergies have been bothering me. I have seasonal allergies and am allergic to maple. I took the Covid test just to make sure and tested negativeMedDRA releases: 2024-11 · check-in free text available
- 2022-11-24
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2022-12-01
Survey response — day 42, dose 5MedDRA: Blood pressure increased, Emergency care, Hypoaesthesia, Medical counselling, Paraesthesia — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: Symptoms: My blood pressure went higher than normal with numbness and tingling the right side of my face and head · Healthcare visit (other): Because of my history I was advised to go to the ER. This is something I've had before but because of my age and family history I can't take it lightly. Everything turned out okay. I was advised to f/u with my primary care physicianMedDRA releases: 2024-11 · check-in free text available
-
2022-12-01
Report sent to call center — day 42, dose 5Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
-
2022-12-02
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2023-01-19
- 2023-04-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-26 | Moderna | |
| 2 | 2021-02-26 | Moderna | |
| 3 | 2021-10-12 | Moderna | No |
| 4 | 2022-04-17 | Moderna | No |
| 5 | 2022-10-20 | Moderna | No |
Call center
5 call center cases
5 successful
1 wait over 3 months for a first call
Free text
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): No
Release 6 — day 28, dose 2
Symptoms: Im having symptoms related to my asthma and am having at times severe coughing spells.
Release 11 — 12 months, dose 2
Symptoms: New allergies to many chemicals used in shampoo, wet wipes, lotion, body wash etc; as well as gold and some antibiotics
Release 11 — day 35, dose 4
Symptoms: I was just diagnosed with a staphylococcus infection at the end of a old abdominal incision. This was done 1977 or 1978.
Healthcare visit (other): Primary care physician
Release 12 — 3 months, dose 4
Symptoms: I had an episode where my blood pressure went a little bit higher than usual along with some numbness and tingling in my fingers and toes. I had a work up and everything was fine. I had an excision and debridement of suprapubic abscess
Healthcare visit (other): Outpatient surgery
Release 12 — 6 months, dose 4
Symptoms: Diagnosed with diverticulitis
Release 12 — day 0, dose 5
Systemic reaction (other): No
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): No
Release 12 — day 28, dose 5
Symptoms: My allergies have been bothering me. I have seasonal allergies and am allergic to maple. I took the Covid test just to make sure and tested negative
Release 12 — day 42, dose 5
Symptoms: My blood pressure went higher than normal with numbness and tingling the right side of my face and head
Healthcare visit (other): Because of my history I was advised to go to the ER. This is something I've had before but because of my age and family history I can't take it lightly. Everything turned out okay. I was advised to f/u 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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Emergency care | · | · | ✓ |
| HCVO | Medical counselling | · | · | ✓ |
| HCVO | Office visit | · | · | ✓ |
| HCVO | Surgery | · | · | ✓ |
| SD | Allergy to chemicals | · | · | ✓ |
| SD | Allergy to metals | · | · | ✓ |
| SD | Blood pressure increased | · | · | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Debridement | · | · | ✓ |
| SD | Diverticulitis | · | · | ✓ |
| SD | Drug hypersensitivity | · | · | ✓ |
| SD | Hypersensitivity | · | · | ✓ |
| SD | Hypoaesthesia | · | · | ✓ |
| SD | Incision site complication | · | · | ✓ |
| SD | Paraesthesia | · | · | ✓ |
| SD | Pelvic abscess | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Staphylococcal infection | · | · | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release