6TQ-68737-99131
3 vaccinations
6 coded responses
12 check-ins
6 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 752 / TX
- Registered
- 2021-02-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
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2021-01-04
Dose 1 — Moderna
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2021-02-02
Dose 2 — Moderna
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2021-02-04
Registered in v-safe
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2021-02-04
Survey response — days 1–6 daily, dose 2MedDRA: Cheilitis, Gingival swelling, Lip swelling, Myalgia, Pollakiuria — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: Swollen bottom lip, irritated, swollen gums, urinated frequently, pulled muscle feelingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-06
Survey response — days 1–6 daily, dose 2MedDRA: Pollakiuria — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Frequent urinationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-07
- 2021-02-08
- 2021-02-16
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2021-02-23
Survey response — day 21, dose 2MedDRA: Noninfective gingivitis, Poor quality sleep — Feeling: FairFree text: Poor sleep and inflamed gums. Not sure if either are related to vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-09
Survey response — day 35, dose 2MedDRA: Aphthous ulcer, Asthenia, Bowel movement irregularity, Gastric disorder — Feeling: Fair · Be unable to work, 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: Loss of energy, stomach and bowel movement issues, and canker soarsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-09
Report sent to call center — day 35, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-16
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2021-05-04
Survey response — 3 months, dose 2MedDRA: Fatigue, Gingival discomfort — Feeling: FairFree text: Irritated gum issues and more sleep needed than normal.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-10-02
Dose 3 — Moderna
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2021-10-24
Survey response — day 21, dose 3MedDRA: Illness, Reaction to previous exposure to any vaccine, Unevaluable event — 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: Symptoms: Continued illness after dose #2 thru July. 48 hrs moderately severe illness following dose #3. · Healthcare visit (other): After dose #2MedDRA releases: 2024-11 · check-in free text available
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2021-10-24
Report sent to call center — day 21, dose 3Be 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)
- 2021-10-26
- 2022-04-02
- 2022-10-02
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-04 | Moderna | |
| 2 | 2021-02-02 | Moderna | |
| 3 | 2021-10-02 | Moderna | No |
Call center
2 call center cases
2 unsuccessful
Free text
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Swollen bottom lip, irritated, swollen gums, urinated frequently, pulled muscle feeling
Systemic reaction (other): Frequent urination
Release 4 — day 21, dose 2
Symptoms: Poor sleep and inflamed gums. Not sure if either are related to vaccine.
Release 5 — day 35, dose 2
Symptoms: Loss of energy, stomach and bowel movement issues, and canker soars
Release 8 — 3 months, dose 2
Symptoms: Irritated gum issues and more sleep needed than normal.
Release 10 — day 21, dose 3
Symptoms: Continued illness after dose #2 thru July. 48 hrs moderately severe illness following dose #3.
Healthcare visit (other): After dose #2
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 | Unevaluable event | · | · | ✓ |
| SD | Aphthous ulcer | ✓ | ✓ | ✓ |
| SD | Asthenia | ✓ | ✓ | ✓ |
| SD | Bowel movement irregularity | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Gastric disorder | ✓ | ✓ | ✓ |
| SD | Gingival discomfort | ✓ | ✓ | ✓ |
| SD | Illness | · | · | ✓ |
| SD | Noninfective gingivitis | ✓ | ✓ | ✓ |
| SD | Poor quality sleep | ✓ | ✓ | ✓ |
| SD | Reaction to previous exposure to any vaccine | · | · | ✓ |
| SRO | Cheilitis | ✓ | ✓ | ✓ |
| SRO | Gingival swelling | ✓ | ✓ | ✓ |
| SRO | Lip swelling | ✓ | ✓ | ✓ |
| SRO | Myalgia | ✓ | ✓ | ✓ |
| SRO | Pollakiuria | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release