CX9-11661-68020
6 vaccinations
4 coded responses
37 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 786 / TX
- Registered
- 2020-12-23
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Registered dependents
WMA-20199-26555
Child or adolescent in my care · Female · 2022-07-14
Timeline
-
2020-12-23
Registered in v-safe
-
2020-12-23
Dose 1 — Moderna
- 2020-12-23
- 2020-12-24
- 2020-12-25
- 2020-12-26
- 2020-12-27
- 2020-12-28
- 2020-12-29
- 2020-12-30
- 2021-01-06
- 2021-01-13
-
2021-01-20
Dose 2 — Moderna
- 2021-01-20
- 2021-01-21
- 2021-01-22
- 2021-01-23
- 2021-01-24
-
2021-01-26
Survey response — days 1–6 daily, dose 2MedDRA: Dermatitis, Pre-existing disease, Sjogren's syndrome — Feeling: Fair · Joint painsFree text: Sjogrens flare, lip dermatitisMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-27
- 2021-02-04
- 2021-02-10
- 2021-02-17
- 2021-02-24
- 2021-03-03
- 2021-04-22
-
2021-07-21
Survey response — 6 months, dose 2MedDRA: Pregnancy — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: PregnancyMedDRA releases: 2024-11 · check-in free text available
-
2021-07-21
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-07-23
- 2021-07-27
-
2021-07-27
Call successfulNot applicable - Accidental Reporting
-
2021-08-13
Dose 3 — Moderna
- 2021-11-12
- 2022-02-11
-
2022-02-22
Dose 4 — Moderna
-
2022-06-28
Dose 5 — Moderna
- 2022-07-14
-
2022-07-26
Survey response — day 28, dose 5MedDRA: Cough, Oropharyngeal pain, Pain, Respiratory tract congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Cough , congestion, sore throat, body achesMedDRA releases: 2024-11 · check-in free text available
-
2022-07-26
Report sent to call center — day 28, dose 5Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2022-07-27
- 2022-07-27
-
2022-08-02
Survey response — day 35, dose 5MedDRA: COVID-19 — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Rebound COVIDMedDRA releases: 2024-11 · check-in free text available
-
2022-08-02
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-08-09
-
2022-09-12
Dose 6 — ModernaCo-administered: Flu
- 2022-09-27
- 2022-09-28
- 2022-10-03
- 2022-10-10
- 2022-10-17
- 2022-10-26
- 2022-12-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-23 | Moderna | |
| 2 | 2021-01-20 | Moderna | |
| 3 | 2021-08-13 | Moderna | No |
| 4 | 2022-02-22 | Moderna | No |
| 5 | 2022-06-28 | Moderna | No |
| 6 | 2022-09-12 | Moderna | Flu |
Call center
2 call center cases
2 successful
Free text
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Sjogrens flare, lip dermatitis
Release 9 — 6 months, dose 2
Symptoms: Pregnancy
Release 12 — day 28, dose 5
Symptoms: Cough , congestion, sore throat, body aches
Release 12 — day 35, dose 5
Symptoms: Rebound COVID
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 | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SRO | Dermatitis | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Sjogren's syndrome | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release