CB6-30184-77380
4 vaccinations
6 coded responses
31 check-ins
5 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 612 / IL
- Registered
- 2021-03-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
4KB-21149-82160
Child or adolescent in my care · Male · 2022-07-13
Timeline
-
2021-03-05
Registered in v-safe
-
2021-03-05
Dose 1 — Moderna
- 2021-03-05
-
2021-03-06
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-03-08
Health check-in — days 1–6 daily, dose 1Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-03-10
- 2021-03-12
- 2021-03-19
- 2021-03-27
-
2021-04-02
Dose 2 — Moderna
- 2021-04-02
-
2021-04-03
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-05
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-09
-
2021-04-19
Survey response — day 14, dose 2MedDRA: Blood glucose decreased — Feeling: GoodFree text: Low blood sugar (probably unrelated)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-24
- 2021-04-30
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2021-05-08
Survey response — day 35, dose 2MedDRA: Nasopharyngitis — Feeling: GoodFree text: I had a cold that I got from my 1 year old. He had a negative COVID test. I never got a COVID test.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-14
-
2021-07-02
Survey response — 3 months, dose 2MedDRA: Headache, Nasal congestion, Nasopharyngitis — Feeling: FairFree text: Cold. Stuffed up nose, headache.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-10-01
Survey response — 6 months, dose 2MedDRA: Cough, Nasopharyngitis, Rhinorrhoea — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: A couple of colds. A cough and runny nose.MedDRA releases: 2024-11 · check-in free text available
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2021-10-01
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
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2021-11-20
Dose 3 — Moderna
-
2021-12-06
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
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2022-04-02
Survey response — 12 months, dose 2MedDRA: Nasopharyngitis — Feeling: Good · Be unable to work or attend schoolFree text: Just various non-covid realated colds.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-23
-
2022-09-09
Dose 4 — Pfizer-BioNTech
- 2022-09-21
- 2022-09-23
- 2022-09-30
- 2022-10-07
- 2022-10-14
- 2022-10-23
- 2022-12-09
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2023-03-10
Survey response — 6 months, dose 4MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-05 | Moderna | |
| 2 | 2021-04-02 | Moderna | |
| 3 | 2021-11-20 | Moderna | No |
| 4 | 2022-09-09 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
Free text
Release 7 — day 14, dose 2
Symptoms: Low blood sugar (probably unrelated)
Release 8 — day 35, dose 2
Symptoms: I had a cold that I got from my 1 year old. He had a negative COVID test. I never got a COVID test.
Release 9 — 3 months, dose 2
Symptoms: Cold. Stuffed up nose, headache.
Release 9 — 6 months, dose 2
Symptoms: A couple of colds. A cough and runny nose.
Release 11 — 12 months, dose 2
Symptoms: Just various non-covid realated colds.
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 | Blood glucose decreased | ✓ | ✓ | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Nasal congestion | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release