92T-11163-55572
5 vaccinations
2 coded responses
68 check-ins
2 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 956 / CA
- Registered
- 2021-06-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
GWH-12641-21653
Child or adolescent in my care · Male · 2022-06-25
G8V-11299-48595
Child or adolescent in my care · Female · 2022-06-25
KJU-67510-51184
Child or adolescent in my care · Male · 2022-06-25
ZGF-18426-98908
Child or adolescent in my care · Female · 2022-06-25
Timeline
-
2021-06-19
Registered in v-safe
-
2021-06-19
Dose 1 — Moderna
- 2021-06-19
- 2021-06-20
- 2021-06-21
- 2021-06-22
- 2021-06-23
- 2021-06-24
- 2021-06-25
- 2021-06-26
- 2021-07-03
- 2021-07-10
- 2021-07-17
-
2021-07-18
Dose 2 — Moderna
- 2021-07-18
-
2021-07-19
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-07-20
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2021-07-21
- 2021-07-22
- 2021-07-23
- 2021-07-24
- 2021-07-25
- 2021-08-01
- 2021-08-08
- 2021-08-15
- 2021-08-22
- 2021-08-29
- 2021-10-17
-
2022-01-14
Dose 3 — Moderna
- 2022-01-14
-
2022-01-15
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Redness, Swelling, Itching · NoneAdult check-in
-
2022-01-16
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Redness, Swelling · Fever · Chills, Joint pains · Be unable to do your normal daily activitiesAdult check-in
- 2022-01-17
- 2022-01-18
- 2022-01-19
- 2022-01-20
- 2022-01-21
- 2022-01-28
- 2022-02-04
- 2022-02-11
- 2022-02-19
- 2022-02-25
- 2022-04-15
- 2022-07-15
-
2022-07-25
Dose 4 — Moderna
- 2022-07-25
-
2022-07-26
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Itching · HeadacheAdult check-in
- 2022-07-27
- 2022-07-28
- 2022-07-29
- 2022-07-30
- 2022-07-31
- 2022-08-01
- 2022-08-08
- 2022-08-17
- 2022-08-22
- 2022-08-29
- 2022-09-05
-
2022-10-17
Dose 5 — Moderna
- 2022-10-17
- 2022-10-18
- 2022-10-19
- 2022-10-20
- 2022-10-21
- 2022-10-22
- 2022-10-23
- 2022-10-24
- 2022-10-31
- 2022-11-08
- 2022-11-14
-
2022-11-21
Survey response — day 35, dose 5MedDRA: Body temperature increased, Bronchial disorder, Cough, Nasopharyngitis, Oropharyngeal pain, Paranasal sinus hypersecretion, Productive cough, Respiratory tract congestion, Rhinorrhoea, Viral infection — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Cold/virus: 7 days: sore throat, sinus drainage, runny nose, cough, 3 days: 99-100 fever, congestion and productive cough/phlegm expectorating from lower bronchiolesMedDRA releases: 2024-11 · check-in free text available
-
2022-11-28
Survey response — day 42, dose 5MedDRA: Respiratory syncytial virus infection, SARS-CoV-2 test negative — Feeling: Fair · Be unable to do your normal daily activitiesFree text: RSV day 14; and negative COVID home test on Day 5MedDRA releases: 2024-11 · check-in free text available
- 2023-01-16
- 2023-04-20
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-06-19 | Moderna | No |
| 2 | 2021-07-18 | Moderna | No |
| 3 | 2022-01-14 | Moderna | No |
| 4 | 2022-07-25 | Moderna | No |
| 5 | 2022-10-17 | Moderna | No |
Free text
Release 12 — day 35, dose 5
Symptoms: Cold/virus: 7 days: sore throat, sinus drainage, runny nose, cough, 3 days: 99-100 fever, congestion and productive cough/phlegm expectorating from lower bronchioles
Release 12 — day 42, dose 5
Symptoms: RSV day 14; and negative COVID home test on Day 5
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 | Body temperature increased | · | · | ✓ |
| SD | Bronchial disorder | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Paranasal sinus hypersecretion | · | · | ✓ |
| SD | Productive cough | · | · | ✓ |
| SD | Respiratory syncytial virus infection | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release