6TT-26687-87749
5 vaccinations
9 coded responses
56 check-ins
8 free-text entries
6 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 900 / CA
- Registered
- 2021-01-05
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-05
Registered in v-safe
-
2021-01-05
Dose 1 — Moderna
- 2021-01-06
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-10
- 2021-01-11
- 2021-01-12
- 2021-01-19
- 2021-01-26
-
2021-02-02
Dose 2 — Moderna
- 2021-02-02
-
2021-02-03
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-02-04
-
2021-02-05
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Redness, Itching · NoneAdult check-in
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-10
- 2021-02-16
- 2021-02-23
-
2021-03-02
Survey response — day 28, dose 2MedDRA: Lymphadenopathy, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Painless Node like mass in left axillary area. Same side as vaccine given. · Healthcare visit (other): Scheduled visit, moved up sooner than originally scheduled.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-02
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-09
-
2021-03-16
Survey response — day 42, dose 2MedDRA: Axillary mass, Blepharitis, Eyelid disorder — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Blepharitis like lesion on left eyelid. This is 2nd recurrence since vaccine. Left axillary nodule.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-16
Report sent to call center — day 42, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-04
-
2021-08-05
Survey response — 6 months, dose 2MedDRA: Wrist fracture — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Wrist fractureMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-05
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-11
-
2021-10-22
Dose 3 — Pfizer-BioNTech
- 2021-10-23
- 2021-10-24
- 2021-10-25
- 2021-10-26
- 2021-10-27
-
2021-10-31
Survey response — day 7, dose 3MedDRA: Dyspnoea, Musculoskeletal chest pain — Feeling: GoodFree text: 1 episode of pain in left rib area where hard to take a deep breath. Later about 15 minutes. Spontaneously resolved. Not other related symptomsMedDRA releases: 2024-11 · check-in free text available
- 2021-11-05
- 2021-11-12
-
2021-11-19
Survey response — day 28, dose 3MedDRA: Cough, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Cough associated with eating and swallowing. · Healthcare visit (other): Appt scheduledMedDRA releases: 2024-11 · check-in free text available
-
2021-11-19
Report sent to call center — day 28, dose 3Get care from a doctor or other healthcare professional1 call case(s)
- 2021-11-23
- 2021-11-26
-
2021-11-30
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2021-12-03
- 2022-01-23
-
2022-04-22
Survey response — 6 months, dose 3MedDRA: Cough, Reactive airways dysfunction syndrome — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Continued intermittent cough. Reactive airway with negative chest x ray.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-22
Report sent to call center — 6 months, dose 3Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-04-25
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-04-27
Dose 4 — Pfizer-BioNTech
-
2022-05-14
Survey response — day 14, dose 4MedDRA: Bronchial hyperreactivity, Burning sensation, Cough, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: Reactive airway, burning and intermittent cough. · Healthcare visit (other): Lung CT and Flovent inhalerMedDRA releases: 2024-11 · check-in free text available
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2022-05-14
Report sent to call center — day 14, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-05-16
- 2022-05-18
- 2022-05-25
- 2022-06-02
- 2022-06-08
- 2022-07-29
-
2022-10-05
Dose 5 — Pfizer-BioNTech
- 2022-10-07
- 2022-10-08
- 2022-10-09
- 2022-10-10
- 2022-10-11
- 2022-10-12
- 2022-10-19
- 2022-10-26
- 2022-11-02
- 2022-11-09
-
2022-11-16
Survey response — day 42, dose 5MedDRA: Headache, Musculoskeletal stiffness, Neck pain — Feeling: Good · Be unable to do your normal daily activitiesFree text: Soreness,stiffness in neck and occipital area on both sidesMedDRA releases: 2024-11 · check-in free text available
- 2023-01-04
- 2023-04-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-05 | Moderna | |
| 2 | 2021-02-02 | Moderna | |
| 3 | 2021-10-22 | Pfizer-BioNTech | No |
| 4 | 2022-04-27 | Pfizer-BioNTech | No |
| 5 | 2022-10-05 | Pfizer-BioNTech | No |
Call center
6 call center cases
5 successful · 1 unsuccessful
Free text
Release 4 — day 28, dose 2
Symptoms: Painless Node like mass in left axillary area. Same side as vaccine given.
Healthcare visit (other): Scheduled visit, moved up sooner than originally scheduled.
Release 5 — day 42, dose 2
Symptoms: Blepharitis like lesion on left eyelid. This is 2nd recurrence since vaccine. Left axillary nodule.
Release 9 — 6 months, dose 2
Symptoms: Wrist fracture
Release 10 — day 7, dose 3
Systemic reaction (other): 1 episode of pain in left rib area where hard to take a deep breath. Later about 15 minutes. Spontaneously resolved. Not other related symptoms
Release 10 — day 28, dose 3
Symptoms: Cough associated with eating and swallowing.
Healthcare visit (other): Appt scheduled
Release 11 — 6 months, dose 3
Symptoms: Continued intermittent cough. Reactive airway with negative chest x ray.
Release 11 — day 14, dose 4
Symptoms: Reactive airway, burning and intermittent cough.
Healthcare visit (other): Lung CT and Flovent inhaler
Release 12 — day 42, dose 5
Symptoms: Soreness,stiffness in neck and occipital area on both sides
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 | Axillary mass | ✓ | ✓ | ✓ |
| SD | Blepharitis | ✓ | ✓ | ✓ |
| SD | Bronchial hyperreactivity | · | · | ✓ |
| SD | Burning sensation | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Eyelid disorder | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SD | Musculoskeletal stiffness | · | · | ✓ |
| SD | Neck pain | · | · | ✓ |
| SD | Reactive airways dysfunction syndrome | · | · | ✓ |
| SD | Wrist fracture | ✓ | · | ✓ |
| SRO | Dyspnoea | · | · | ✓ |
| SRO | Musculoskeletal chest pain | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release