6YM-28089-70271
4 vaccinations
4 coded responses
42 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 727 / AR
- Registered
- 2021-01-22
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
3QH-16645-13641
Child or adolescent in my care · Male · 2022-06-27
Timeline
-
2021-01-22
Registered in v-safe
-
2021-01-22
Dose 1 — Moderna
-
2021-01-22
Health check-in — day 0, dose 1Feeling: Good · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
- 2021-01-23
- 2021-01-24
-
2021-01-26
Survey response — days 1–6 daily, dose 1MedDRA: Rosacea — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: I have approximately quarter-sized, non-itchy, red patches on face - similar in appearance to rosacea. I noticed the patches on the evening I got the vaccine. I have experienced this intermittently before so it may be completely unrelated to vaccination, but I noticed another individual who got the vaccine the same day I did has the patches as well so thought it worth noting.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-02-05
- 2021-02-12
-
2021-02-19
Dose 2 — Moderna
- 2021-02-19
-
2021-02-20
Survey response — days 1–6 daily, dose 2MedDRA: Peripheral swelling, Swelling face — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tirednessFree text: face and hands slightly swollenMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-02-26
- 2021-03-05
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-04-02
- 2021-05-21
- 2021-08-20
-
2021-10-25
Dose 3 — Moderna
-
2021-10-26
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend schoolAdult check-in
- 2021-10-27
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-11
-
2021-11-15
Survey response — day 21, dose 3MedDRA: Nasopharyngitis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Cold symptomsMedDRA releases: 2024-11 · check-in free text available
-
2021-11-15
Report sent to call center — day 21, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
-
2021-11-17
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2022-01-24
-
2022-04-25
Survey response — 6 months, dose 3MedDRA: Dyspnoea, Fatigue, Headache, Migraine, Pre-existing disease — Feeling: Good · Be unable to work or attend school, 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 visit, Emergency room or emergency department visitFree text: Post-covid infection 02/07/2022 have had shortness of breath, fatigue and headache symptoms for >6 weeks and continue to have increased migrainesMedDRA releases: 2024-11 · check-in free text available
-
2022-04-25
Report sent to call center — 6 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
-
2022-04-27
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
-
2022-09-12
Dose 4 — Pfizer-BioNTechCo-administered: Flu
- 2022-10-08
- 2022-10-10
- 2022-10-17
- 2022-10-24
- 2022-12-12
- 2023-03-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-22 | Moderna | |
| 2 | 2021-02-19 | Moderna | |
| 3 | 2021-10-25 | Moderna | No |
| 4 | 2022-09-12 | Pfizer-BioNTech | Flu |
Call center
2 call center cases
2 successful
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): I have approximately quarter-sized, non-itchy, red patches on face - similar in appearance to rosacea. I noticed the patches on the evening I got the vaccine. I have experienced this intermittently before so it may be completely unrelated to vaccination, but I noticed another individual who got the vaccine the same day I did has the patches as well so thought it worth noting.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): face and hands slightly swollen
Release 10 — day 21, dose 3
Symptoms: Cold symptoms
Release 11 — 6 months, dose 3
Symptoms: Post-covid infection 02/07/2022 have had shortness of breath, fatigue and headache symptoms for >6 weeks and continue to have increased migraines
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 |
|---|---|---|---|---|
| SD | Dyspnoea | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Migraine | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SRO | Peripheral swelling | ✓ | ✓ | ✓ |
| SRO | Rosacea | ✓ | ✓ | ✓ |
| SRO | Swelling face | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release