8X7-88099-20319
3 vaccinations
4 coded responses
15 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 018 / MA
- Registered
- 2021-12-20
- Relationship
- Adult relative or friend
- Guardian
- 4ZZ-14183-65686
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-13
Dose 1 — Moderna
-
2021-03-13
Dose 2 — Moderna
-
2021-12-20
Registered in v-safe
-
2021-12-20
Dose 3 — Moderna
-
2021-12-20
Survey response — day 0, dose 3, dependentMedDRA: Nausea, Pre-existing disease — Feeling: Good · Muscle or body aches, NauseaFree text: The 2 symptoms checked above are not from the vaccine. She has a spine injury and is on a new med which is probably causing the nausea.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-21
Health check-in — days 1–6 daily, dose 3, dependentFeeling: Good · Site: Pain · Muscle or body aches, NauseaAdult check-in
- 2021-12-22
-
2021-12-24
Health check-in — days 1–6 daily, dose 3, dependentFeeling: Fair · Nausea · Be unable to do your normal daily activitiesAdult check-in
- 2021-12-25
- 2021-12-26
- 2021-12-27
-
2022-01-05
Survey response — day 14, dose 3, dependentMedDRA: Anxiety, Fear, Nausea — Feeling: Fair · Be unable to do their normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Anxiety, nausea, fear of being alone.MedDRA releases: 2024-11 · check-in free text available
-
2022-01-05
Report sent to call center — day 14, dose 3, dependentBe unable to do their normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-01-10
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-01-12
-
2022-01-17
Survey response — day 28, dose 3, dependentMedDRA: Abdominal pain, Back pain, Nausea — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Pain in back, abdomen, nauseaMedDRA releases: 2024-11 · check-in free text available
-
2022-01-24
Survey response — day 35, dose 3, dependentMedDRA: Anxiety, Back pain, Nausea, Panic attack — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Anxiety with panic attacks, back pain & nausea.MedDRA releases: 2024-11 · check-in free text available
- 2022-02-02
- 2022-03-21
- 2022-06-20
- 2022-12-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-13 | Moderna | No |
| 2 | 2021-03-13 | Moderna | No |
| 3 | 2021-12-20 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 10 — day 0, dose 3, dependent
Systemic reaction (other): The 2 symptoms checked above are not from the vaccine. She has a spine injury and is on a new med which is probably causing the nausea.
Release 10 — day 14, dose 3, dependent
Symptoms: Anxiety, nausea, fear of being alone.
Release 10 — day 28, dose 3, dependent
Symptoms: Pain in back, abdomen, nausea
Release 11 — day 35, dose 3, dependent
Symptoms: Anxiety with panic attacks, back pain & nausea.
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 | Abdominal pain | · | · | ✓ |
| SD | Anxiety | · | · | ✓ |
| SD | Back pain | · | · | ✓ |
| SD | Fear | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Panic attack | · | · | ✓ |
| SRO | Nausea | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release