8G6-11573-98336
1 vaccination
4 coded responses
12 check-ins
4 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 666 / KS
- Registered
- 2020-12-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2020-12-31
Registered in v-safe
-
2020-12-31
Dose 1 — Moderna
- 2020-12-31
- 2021-01-01
- 2021-01-02
- 2021-01-03
-
2021-01-04
Survey response — days 1–6 daily, dose 1MedDRA: Cough — Feeling: Fair · Fever · Fatigue or tirednessFree text: CoughMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-05
Survey response — days 1–6 daily, dose 1MedDRA: Cough, Sinus congestion — Feeling: Fair · Fatigue or tiredness · Be unable to workFree text: Cough, sinus congestionMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-05
-
2021-01-06
Survey response — days 1–6 daily, dose 1MedDRA: SARS-CoV-2 test positive — Feeling: Fair · Be unable to workFree text: Tested positive for covid on 1/4/21MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-06
-
2021-01-07
Survey response — day 7, dose 1MedDRA: Ageusia, COVID-19, Respiratory tract congestion — Feeling: Fair · Fatigue or tiredness · Be unable to workFree text: Congestion. No taste. Covid positiveMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-07
-
2021-01-10
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-01-16
- 2021-01-21
- 2021-07-01
- 2021-12-31
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-31 | Moderna |
Call center
3 call center cases
3 successful
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Cough
Systemic reaction (other): Cough, sinus congestion
Systemic reaction (other): Tested positive for covid on 1/4/21
Release 1 — day 7, dose 1
Systemic reaction (other): Congestion. No taste. Covid positive
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 |
|---|---|---|---|---|
| SRO | Ageusia | ✓ | ✓ | ✓ |
| SRO | Cough | ✓ | ✓ | ✓ |
| SRO | COVID-19 | ✓ | ✓ | ✓ |
| SRO | Respiratory tract congestion | ✓ | ✓ | ✓ |
| SRO | SARS-CoV-2 test positive | ✓ | ✓ | ✓ |
| SRO | Sinus congestion | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release