EZB-17810-81192
3 vaccinations
10 coded responses
33 check-ins
9 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 983 / WA
- Registered
- 2021-03-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
NBF-29667-75596
Child or adolescent in my care · Male · 2021-11-09
Timeline
-
2021-03-13
Registered in v-safe
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2021-03-13
Dose 1 — Moderna
- 2021-03-13
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2021-03-14
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Headache, Muscle or body achesAdult check-in
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
-
2021-03-19
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness, Vertigo — Feeling: Fair · Headache, Fatigue or tirednessFree text: A little dizzy/vertigo like Im about to have a migraine. Slightly improved with food but not much.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-20
- 2021-03-27
- 2021-04-06
-
2021-04-10
Dose 2 — Moderna
-
2021-04-10
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-11
Survey response — days 1–6 daily, dose 2MedDRA: Back pain, Chest pain, Headache, Tremor — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to work, Be unable to do your normal daily activitiesFree text: Back pain, random sharp stabbing pains in back, chest and head. Whole body shaking.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-12
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to workAdult check-in
-
2021-04-13
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness, NauseaAdult check-in
- 2021-04-14
- 2021-04-15
- 2021-04-16
- 2021-04-17
- 2021-04-26
- 2021-05-01
- 2021-05-10
- 2021-05-15
- 2021-05-22
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2021-07-10
Survey response — 3 months, dose 2MedDRA: Dizziness, Dyspnoea, Tenderness — Feeling: FairFree text: Shortness of breath. Light headed when I bend over. Left side tender when I take a deep breath.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-10-09
Survey response — 6 months, dose 2MedDRA: Chest discomfort, Headache, Nausea — Feeling: FairFree text: Nausea, headaches, some chest tightnessMedDRA releases: 2024-11 · check-in free text available
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2022-01-07
Dose 3 — Moderna
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2022-01-21
Survey response — day 14, dose 3MedDRA: Pain of skin, Pruritus, Urticaria — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Very itchy skin with hives that comes and goes in different places. Makes it hard to wear fitted clothing or anything with elastic.MedDRA releases: 2024-11 · check-in free text available
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2022-01-28
Survey response — day 21, dose 3MedDRA: Discomfort, Pruritus, Urticaria — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Itchy hives that come and go, but are very uncomfortable when they are in an active wave.MedDRA releases: 2024-11 · check-in free text available
- 2022-02-04
- 2022-02-12
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2022-02-18
Survey response — day 42, dose 3MedDRA: Discomfort, Pruritus, Self-medication, Urticaria — Feeling: Fair · Be unable to do your normal daily activitiesFree text: A few times, the itchy hives were much worse than usual. Usually a 10mg Zyrtec addresses it, but twice there was still discomfort despite a 10 mg dose of Zyrtec.MedDRA releases: 2024-11 · check-in free text available
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2022-04-08
Survey response — 3 months, dose 3MedDRA: Abdominal pain lower, Urticaria — 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 · Emergency room or emergency department visitFree text: Lower right abdominal pain. Continuation of breakouts of hives.MedDRA releases: 2024-11 · check-in free text available
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2022-04-08
Report sent to call center — 3 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · 1 call case(s)
- 2022-04-22
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2022-07-08
Survey response — 6 months, dose 3MedDRA: Heart rate decreased, Muscle spasms — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Involuntary muscle spasms. Lowered heart rate below 40 when asleep.MedDRA releases: 2024-11 · check-in free text available
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2023-01-07
Survey response — 12 months, dose 3MedDRA: COVID-19, Cough, 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 consultationMedDRA releases: 2024-11
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2023-01-07
Report sent to call center — 12 months, dose 3Be 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)
- 2023-01-09
- 2023-01-09
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-13 | Moderna | |
| 2 | 2021-04-10 | Moderna | |
| 3 | 2022-01-07 | Moderna | No |
Call center
2 call center cases
2 unsuccessful
Free text
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): A little dizzy/vertigo like Im about to have a migraine. Slightly improved with food but not much.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Back pain, random sharp stabbing pains in back, chest and head. Whole body shaking.
Release 9 — 3 months, dose 2
Symptoms: Shortness of breath. Light headed when I bend over. Left side tender when I take a deep breath.
Release 10 — 6 months, dose 2
Symptoms: Nausea, headaches, some chest tightness
Release 11 — day 14, dose 3
Symptoms: Very itchy skin with hives that comes and goes in different places. Makes it hard to wear fitted clothing or anything with elastic.
Release 11 — day 21, dose 3
Symptoms: Itchy hives that come and go, but are very uncomfortable when they are in an active wave.
Release 11 — day 42, dose 3
Symptoms: A few times, the itchy hives were much worse than usual. Usually a 10mg Zyrtec addresses it, but twice there was still discomfort despite a 10 mg dose of Zyrtec.
Release 11 — 3 months, dose 3
Symptoms: Lower right abdominal pain. Continuation of breakouts of hives.
Release 12 — 6 months, dose 3
Symptoms: Involuntary muscle spasms. Lowered heart rate below 40 when asleep.
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 lower | · | · | ✓ |
| SD | Chest discomfort | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Discomfort | · | · | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Dyspnoea | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Heart rate decreased | · | · | ✓ |
| SD | Muscle spasms | · | · | ✓ |
| SD | Nausea | · | · | ✓ |
| SD | Pain of skin | · | · | ✓ |
| SD | Pruritus | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Tenderness | ✓ | ✓ | ✓ |
| SD | Urticaria | · | · | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Chest pain | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Tremor | ✓ | ✓ | ✓ |
| SRO | Vertigo | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release