AVX-21211-54939
2 vaccinations
2 coded responses
12 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 971 / OR
- Registered
- 2020-12-23
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-23
Registered in v-safe
-
2020-12-23
Dose 1 — Moderna
- 2020-12-23
-
2020-12-26
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
- 2020-12-30
- 2021-01-13
-
2021-01-22
Dose 2 — Moderna
- 2021-01-22
-
2021-01-23
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2021-01-24
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to workAdult check-in
-
2021-01-25
Survey response — days 1–6 daily, dose 2MedDRA: Lymphadenopathy — Feeling: Good · Site: Redness, Swelling · Fatigue or tirednessFree text: Swollen supraclavicular node on the side of my injection.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Swelling · Fatigue or tiredness, DiarrheaAdult check-in
- 2021-02-07
- 2021-04-25
-
2022-01-22
Survey response — 12 months, dose 2MedDRA: COVID-19, Cough, Dyspnoea — Feeling: Poor · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Cough SOB +Covid infection.MedDRA releases: 2024-11 · check-in free text available
-
2022-01-22
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-01-25
-
2022-01-28
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-23 | Moderna | |
| 2 | 2021-01-22 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Swollen supraclavicular node on the side of my injection.
Release 11 — 12 months, dose 2
Symptoms: Cough SOB +Covid infection.
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 | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dyspnoea | · | · | ✓ |
| SRO | Lymphadenopathy | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release