6ST-18789-70591
4 vaccinations
7 coded responses
31 check-ins
7 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 299 / SC
- Registered
- 2021-03-28
- Relationship
- Self
- Race
- N/A
- Ethnicity
- N/A
Timeline
-
2021-03-26
Dose 1 — Moderna
-
2021-03-28
Registered in v-safe
-
2021-03-28
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-29
- 2021-03-30
- 2021-04-01
-
2021-04-02
Survey response — day 7, dose 1MedDRA: Hypersensitivity — Feeling: Fair · HeadacheFree text: Allergies to pollen, paint and dustno aches/pains related to the vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-10
-
2021-04-23
Dose 2 — Moderna
-
2021-04-24
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: There is a mild soreness at the injection site, but otherwise pain free.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-25
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pain, Injection site warmth — Feeling: GoodFree text: Slight soreness & warmth at the injection site, (same as when I get a flu shot), but no other issues.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-26
- 2021-04-27
- 2021-04-29
- 2021-05-02
- 2021-05-08
- 2021-05-14
- 2021-05-21
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2021-05-28
Survey response — day 35, dose 2MedDRA: Hypersensitivity, Office visit, Oropharyngeal pain — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Sore throat--allergy. Went to urgent care to be sure it was nothing more.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-28
Report sent to call center — day 35, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-06-04
- 2021-07-23
- 2021-10-22
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2021-10-25
Dose 3 — Moderna
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2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2024-11 · check-in free text available
- 2021-11-01
- 2021-11-09
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
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2022-01-25
Survey response — 3 months, dose 3MedDRA: Headache, Lethargy, Medical counselling, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test, Seasonal allergy, Sinus congestion — 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 consultation, Outpatient clinic or urgent care clinic visitFree text: Symptoms: Allergy to Star Gazer Lillies. Had congestion in my sinuses, sore throat, headache. After a few days still felt lethargic and congested. Got Co-Vid test that proved "inconclusive." Never had a fever or chest pain. · Healthcare visit (other): Co-Vid test (drive through)MedDRA releases: 2024-11 · check-in free text available
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2022-01-25
Report sent to call center — 3 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-01-26
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-04-26
-
2022-07-26
Dose 4 — Moderna
- 2022-10-27
- 2022-10-27
- 2023-01-26
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-26 | Moderna | |
| 2 | 2021-04-23 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-07-26 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): No
Release 6 — day 7, dose 1
Systemic reaction (other): Allergies to pollen, paint and dustno aches/pains related to the vaccine.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): There is a mild soreness at the injection site, but otherwise pain free.
Systemic reaction (other): Slight soreness & warmth at the injection site, (same as when I get a flu shot), but no other issues.
Release 8 — day 35, dose 2
Symptoms: Sore throat--allergy. Went to urgent care to be sure it was nothing more.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): No
Release 11 — 3 months, dose 3
Symptoms: Allergy to Star Gazer Lillies. Had congestion in my sinuses, sore throat, headache. After a few days still felt lethargic and congested. Got Co-Vid test that proved "inconclusive." Never had a fever or chest pain.
Healthcare visit (other): Co-Vid test (drive through)
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 | Medical counselling | · | · | ✓ |
| HCVO | SARS-CoV-2 test | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Hypersensitivity | ✓ | ✓ | ✓ |
| SD | Lethargy | · | · | ✓ |
| SD | Office visit | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | SARS-CoV-2 test | · | · | ✓ |
| SD | Seasonal allergy | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SRO | Hypersensitivity | ✓ | ✓ | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Injection site warmth | ✓ | ✓ | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release