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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

  1. 2021-01-04
    Dose 1 — Moderna
  2. 2021-02-02
    Dose 2 — Moderna
  3. 2021-02-04
    Registered in v-safe
  4. 2021-02-04
    Survey response — days 1–6 daily, dose 2
    MedDRA: 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 activities
    Free text: Swollen bottom lip, irritated, swollen gums, urinated frequently, pulled muscle feeling
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-02-06
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pollakiuria — Feeling: Good · Site: Pain · Fatigue or tiredness
    Free text: Frequent urination
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-07
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  7. 2021-02-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  8. 2021-02-16
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  9. 2021-02-23
    Survey response — day 21, dose 2
    MedDRA: Noninfective gingivitis, Poor quality sleep — Feeling: Fair
    Free 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
  10. 2021-03-09
    Survey response — day 35, dose 2
    MedDRA: 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 consultation
    Free text: Loss of energy, stomach and bowel movement issues, and canker soars
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-03-09
    Report sent to call center — day 35, dose 2
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  12. 2021-03-16
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in
  13. 2021-05-04
    Survey response — 3 months, dose 2
    MedDRA: Fatigue, Gingival discomfort — Feeling: Fair
    Free text: Irritated gum issues and more sleep needed than normal.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-10-02
    Dose 3 — Moderna
  15. 2021-10-24
    Survey response — day 21, dose 3
    MedDRA: 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 consultation
    Free text: Symptoms: Continued illness after dose #2 thru July. 48 hrs moderately severe illness following dose #3. · Healthcare visit (other): After dose #2
    MedDRA releases: 2024-11 · check-in free text available
  16. 2021-10-24
    Report sent to call center — day 21, dose 3
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · 1 call case(s)
  17. 2021-10-26
  18. 2022-04-02
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  19. 2022-10-02
    Health check-in — 12 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-04Moderna
22021-02-02Moderna
32021-10-02Moderna No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-04

Systemic reaction (other): Swollen bottom lip, irritated, swollen gums, urinated frequently, pulled muscle feeling

2021-02-06

Systemic reaction (other): Frequent urination

Release 4 — day 21, dose 2

2021-02-23

Symptoms: Poor sleep and inflamed gums. Not sure if either are related to vaccine.

Release 5 — day 35, dose 2

2021-03-09

Symptoms: Loss of energy, stomach and bowel movement issues, and canker soars

Release 8 — 3 months, dose 2

2021-05-04

Symptoms: Irritated gum issues and more sleep needed than normal.

Release 10 — day 21, dose 3

2021-10-24

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

FieldPreferred term2021-092023-042024-11
HCVOUnevaluable event · · ✓
SDAphthous ulcer ✓ ✓ ✓
SDAsthenia ✓ ✓ ✓
SDBowel movement irregularity ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDGastric disorder ✓ ✓ ✓
SDGingival discomfort ✓ ✓ ✓
SDIllness · · ✓
SDNoninfective gingivitis ✓ ✓ ✓
SDPoor quality sleep ✓ ✓ ✓
SDReaction to previous exposure to any vaccine · · ✓
SROCheilitis ✓ ✓ ✓
SROGingival swelling ✓ ✓ ✓
SROLip swelling ✓ ✓ ✓
SROMyalgia ✓ ✓ ✓
SROPollakiuria ✓ ✓ ✓

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