6YZ-31928-28959
2 vaccinations
5 coded responses
27 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 926 / CA
- Registered
- 2021-03-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-04
Registered in v-safe
-
2021-03-04
Dose 1 — Moderna
-
2021-03-04
Survey response — day 0, dose 1MedDRA: Dizziness — Feeling: Good · Site: SwellingFree text: Little dizzyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-04-01
-
2021-04-03
Dose 2 — Moderna
- 2021-04-03
-
2021-04-04
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-09
- 2021-04-10
-
2021-04-17
Survey response — day 14, dose 2MedDRA: Arthralgia, Fatigue, Pain in extremity — Feeling: FairFree text: Pain in my legs that keep me up at night. (Thighs and hips). Fatigue many hours of the day.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-24
Survey response — day 21, dose 2MedDRA: Breast pain, Breast swelling, Pain in extremity — Feeling: GoodFree text: Same leg pains. Forgot to report last week and continues this week - pain in both breasts with swellingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-01
- 2021-05-08
-
2021-05-15
Survey response — day 42, dose 2MedDRA: Breast pain, Breast swelling — Feeling: FairFree text: Breast pain and swelling has continued the last week.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-04
-
2021-10-02
Survey response — 6 months, dose 2MedDRA: Anxiety, Chest pain, Headache, Nausea, Office visit, Palpitations, Pre-existing disease — Feeling: Fair · 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: Ive been having heart palpitations and some pain in my chest. Im 68 years old and Im worried. Also my anxiety is out of control and making my stomach sick with nausea. · Healthcare visit (other): In person alsoMedDRA releases: 2024-11 · check-in free text available
-
2021-10-02
Report sent to call center — 6 months, dose 2Be 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)
- 2021-10-07
- 2021-10-08
- 2021-10-11
- 2022-04-04
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-04 | Moderna | |
| 2 | 2021-04-03 | Moderna |
Call center
1 call center case
1 unsuccessful
Free text
Release 5 — day 0, dose 1
Systemic reaction (other): Little dizzy
Release 7 — day 14, dose 2
Symptoms: Pain in my legs that keep me up at night. (Thighs and hips). Fatigue many hours of the day.
Release 7 — day 21, dose 2
Symptoms: Same leg pains. Forgot to report last week and continues this week - pain in both breasts with swelling
Release 8 — day 42, dose 2
Symptoms: Breast pain and swelling has continued the last week.
Release 9 — 6 months, dose 2
Symptoms: Ive been having heart palpitations and some pain in my chest. Im 68 years old and Im worried. Also my anxiety is out of control and making my stomach sick with nausea.
Healthcare visit (other): In person also
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 | Office visit | · | · | ✓ |
| SD | Anxiety | · | · | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Breast pain | ✓ | ✓ | ✓ |
| SD | Breast swelling | ✓ | ✓ | ✓ |
| SD | Chest pain | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Palpitations | · | · | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release