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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

  1. 2021-01-26
    Dose 1 — Moderna
  2. 2021-02-24
    Registered in v-safe
  3. 2021-02-24
    Health check-in — day 28, dose 1
    Feeling: Fair
    Adult check-in
  4. 2021-02-26
    Dose 2 — Moderna
  5. 2021-03-02
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Swelling, Itching · Fatigue or tiredness
    Adult check-in
  6. 2021-03-03
    Survey response — days 1–6 daily, dose 2
    MedDRA: No adverse event — Feeling: Good · Site: Pain · Fatigue or tiredness
    Free text: No
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-03-04
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  8. 2021-03-05
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  9. 2021-03-14
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  10. 2021-03-19
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  11. 2021-03-26
    Survey response — day 28, dose 2
    MedDRA: Cough, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free 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
  12. 2021-03-26
    Report sent to call center — day 28, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  13. 2021-04-09
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-05-28
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-08-27
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-10-12
    Dose 3 — Moderna
  17. 2022-01-19
  18. 2022-01-24
  19. 2022-02-28
    Survey response — 12 months, dose 2
    MedDRA: Allergy to chemicals, Allergy to metals, Drug hypersensitivity — Feeling: Good
    Free text: New allergies to many chemicals used in shampoo, wet wipes, lotion, body wash etc; as well as gold and some antibiotics
    MedDRA releases: 2024-11 · check-in free text available
  20. 2022-04-17
    Dose 4 — Moderna
  21. 2022-04-26
    Health check-in — day 7, dose 4
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  22. 2022-05-02
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  23. 2022-05-13
    Health check-in — day 21, dose 4
    Feeling: Fair
    Adult check-in
  24. 2022-05-15
    Health check-in — day 28, dose 4
    Feeling: Fair
    Adult check-in
  25. 2022-05-23
    Survey response — day 35, dose 4
    MedDRA: 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 visit
    Free 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 physician
    MedDRA releases: 2024-11 · check-in free text available
  26. 2022-05-23
    Report sent to call center — day 35, dose 4
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  27. 2022-05-24
  28. 2022-05-24
  29. 2022-05-24
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  30. 2022-05-24
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  31. 2022-05-29
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  32. 2022-07-19
    Survey response — 3 months, dose 4
    MedDRA: 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 visit
    Free 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 surgery
    MedDRA releases: 2024-11 · check-in free text available
  33. 2022-07-19
    Report sent to call center — 3 months, dose 4
    Get care from a doctor or other healthcare professional
    Emergency room or emergency department visit · 1 call case(s)
  34. 2022-07-20
  35. 2022-07-20
  36. 2022-07-20
  37. 2022-07-25
    Call successful
    Not applicable - Accidental Reporting
  38. 2022-10-16
    Survey response — 6 months, dose 4
    MedDRA: Diverticulitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit
    Free text: Diagnosed with diverticulitis
    MedDRA releases: 2024-11 · check-in free text available
  39. 2022-10-16
    Report sent to call center — 6 months, dose 4
    Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
  40. 2022-10-17
    Call successful
    Not applicable - Accidental Reporting
  41. 2022-10-20
    Dose 5 — Moderna
  42. 2022-10-20
    Survey response — day 0, dose 5
    MedDRA: No adverse event — Feeling: Good · Site: Pain, Swelling
    Free text: No
    MedDRA releases: 2024-11 · check-in free text available
  43. 2022-10-22
    Survey response — days 1–6 daily, dose 5
    MedDRA: No adverse event — Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness
    Free text: No
    MedDRA releases: 2024-11 · check-in free text available
  44. 2022-10-24
    Health check-in — days 1–6 daily, dose 5
    Feeling: Fair · Site: Pain, Swelling, Itching · Fatigue or tiredness
    Adult check-in
  45. 2022-10-25
    Health check-in — days 1–6 daily, dose 5
    Feeling: Fair · Fatigue or tiredness
    Adult check-in
  46. 2022-10-26
    Health check-in — days 1–6 daily, dose 5
    Feeling: Fair · Fatigue or tiredness
    Adult check-in
  47. 2022-10-27
    Health check-in — day 7, dose 5
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  48. 2022-11-03
    Health check-in — day 14, dose 5
    Feeling: Good
    Adult check-in
  49. 2022-11-10
    Health check-in — day 21, dose 5
    Feeling: Good
    Adult check-in
  50. 2022-11-19
    Survey response — day 28, dose 5
    MedDRA: Hypersensitivity, Pre-existing disease, SARS-CoV-2 test negative — Feeling: Fair
    Free 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 negative
    MedDRA releases: 2024-11 · check-in free text available
  51. 2022-11-24
    Health check-in — day 35, dose 5
    Feeling: Good
    Adult check-in
  52. 2022-12-01
    Survey response — day 42, dose 5
    MedDRA: 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 visit
    Free 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 physician
    MedDRA releases: 2024-11 · check-in free text available
  53. 2022-12-01
    Report sent to call center — day 42, dose 5
    Get care from a doctor or other healthcare professional
    Emergency room or emergency department visit · 1 call case(s)
  54. 2022-12-02
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  55. 2023-01-19
    Health check-in — 3 months, dose 5
    Feeling: Fair
    Adult check-in
  56. 2023-04-20
    Health check-in — 6 months, dose 5
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-26Moderna
22021-02-26Moderna
32021-10-12Moderna No
42022-04-17Moderna No
52022-10-20Moderna No

Call center

5 call center cases

5 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): No

Release 6 — day 28, dose 2

2021-03-26

Symptoms: Im having symptoms related to my asthma and am having at times severe coughing spells.

Release 11 — 12 months, dose 2

2022-02-28

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

2022-05-23

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

2022-07-19

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

2022-10-16

Symptoms: Diagnosed with diverticulitis

Release 12 — day 0, dose 5

2022-10-20

Systemic reaction (other): No

Release 12 — days 1–6 daily, dose 5

2022-10-22

Systemic reaction (other): No

Release 12 — day 28, dose 5

2022-11-19

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

2022-12-01

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

FieldPreferred term2021-092023-042024-11
HCVOEmergency care · · ✓
HCVOMedical counselling · · ✓
HCVOOffice visit · · ✓
HCVOSurgery · · ✓
SDAllergy to chemicals · · ✓
SDAllergy to metals · · ✓
SDBlood pressure increased · · ✓
SDCough ✓ ✓ ✓
SDDebridement · · ✓
SDDiverticulitis · · ✓
SDDrug hypersensitivity · · ✓
SDHypersensitivity · · ✓
SDHypoaesthesia · · ✓
SDIncision site complication · · ✓
SDParaesthesia · · ✓
SDPelvic abscess · · ✓
SDPre-existing disease ✓ ✓ ✓
SDSARS-CoV-2 test negative · · ✓
SDStaphylococcal infection · · ✓
SRONo adverse event ✓ ✓ ✓

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