877-94300-33609
3 vaccinations
3 coded responses
26 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 21-25
- ZIP prefix
- 537 / WI
- Registered
- 2021-04-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-05
Registered in v-safe
-
2021-04-05
Dose 1 — Moderna
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2021-04-05
Survey response — day 0, dose 1MedDRA: Insomnia — Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tirednessFree text: Had a rough night's sleepMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-06
Survey response — days 1–6 daily, dose 1MedDRA: Oropharyngeal pain — Feeling: Fair · Site: PainFree text: Sore throatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-07
- 2021-04-08
- 2021-04-09
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2021-04-11
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Fever · Rash, not including the immediate area around the injection siteAdult check-in
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2021-04-12
Health check-in — day 7, dose 1Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-04-19
- 2021-04-26
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2021-05-03
Dose 2 — Moderna
- 2021-05-03
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2021-05-04
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Itching · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
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2021-05-05
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-05-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-05-07
- 2021-05-08
- 2021-05-09
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2021-05-10
Health check-in — day 7, dose 2Feeling: Fair · Fatigue or tiredness, Diarrhea, Abdominal painAdult check-in
- 2021-05-17
- 2021-05-24
- 2021-05-31
- 2021-06-07
- 2021-06-14
- 2021-08-02
- 2021-11-01
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2021-12-10
Dose 3 — Moderna
- 2022-06-10
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2022-12-10
Survey response — 12 months, dose 3MedDRA: Perineal injury, Urinary tract infection — 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 visit, HospitalizationFree text: Birth, 3rd degree tear from birth, UTIMedDRA releases: 2024-11 · check-in free text available
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2022-12-10
Report sent to call center — 12 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 · Hospitalization · 1 call case(s)
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2022-12-13
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-05 | Moderna | |
| 2 | 2021-05-03 | Moderna | |
| 3 | 2021-12-10 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 6 — day 0, dose 1
Systemic reaction (other): Had a rough night's sleep
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): Sore throat
Release 12 — 12 months, dose 3
Symptoms: Birth, 3rd degree tear from birth, UTI
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 | Perineal injury | · | · | ✓ |
| SD | Urinary tract infection | · | · | ✓ |
| SRO | Insomnia | ✓ | ✓ | ✓ |
| SRO | Oropharyngeal pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release