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FWC-16635-77226

3 vaccinations 5 coded responses 29 check-ins 5 free-text entries 0 call cases
Sex
Female
Age at first dose
36-40
ZIP prefix
342 / FL
Registered
2021-05-09
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
DVS-14631-35001 Child or adolescent in my care · Male · 2022-06-26

Timeline

  1. 2021-04-09
    Dose 1 — Moderna
  2. 2021-05-07
    Dose 2 — Moderna
  3. 2021-05-09
    Registered in v-safe
  4. 2021-05-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Joint pains, Abdominal pain
    Adult check-in
  5. 2021-05-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Fatigue or tiredness
    Adult check-in
  6. 2021-05-11
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  7. 2021-05-12
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  8. 2021-05-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  9. 2021-05-14
    Health check-in — day 7, dose 2
    Feeling: Fair · Headache, Fatigue or tiredness
    Adult check-in
  10. 2021-05-21
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  11. 2021-05-28
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  12. 2021-06-04
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-06-11
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-06-18
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-08-06
    Survey response — 3 months, dose 2
    MedDRA: Fatigue, Gastric disorder — Feeling: Fair
    Free text: Fatigue, stomach issues
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  16. 2021-11-05
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-12-12
    Dose 3 — Moderna
  18. 2021-12-12
    Health check-in — day 0, dose 3
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  19. 2021-12-13
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness
    Adult check-in
  20. 2021-12-14
    Survey response — days 1–6 daily, dose 3
    MedDRA: Axillary pain — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Fatigue or tiredness
    Free text: Armpit soreness
    MedDRA releases: 2024-11 · check-in free text available
  21. 2021-12-15
    Survey response — days 1–6 daily, dose 3
    MedDRA: Axillary pain — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Fatigue or tiredness
    Free text: Armpit soreness
    MedDRA releases: 2024-11 · check-in free text available
  22. 2021-12-16
    Survey response — days 1–6 daily, dose 3
    MedDRA: Axillary pain — Feeling: Good · Site: Pain · Fatigue or tiredness
    Free text: Slight armpit soreness
    MedDRA releases: 2024-11 · check-in free text available
  23. 2021-12-17
    Survey response — days 1–6 daily, dose 3
    MedDRA: Axillary pain — Feeling: Good · Fatigue or tiredness
    Free text: Mild armpit soreness
    MedDRA releases: 2024-11 · check-in free text available
  24. 2021-12-18
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  25. 2021-12-19
    Health check-in — day 7, dose 3
    Feeling: Fair · Fever · Fatigue or tiredness
    Adult check-in
  26. 2021-12-26
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  27. 2022-01-02
    Health check-in — day 21, dose 3
    Feeling: Fair
    Adult check-in
  28. 2022-01-09
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  29. 2022-01-16
    Health check-in — day 35, dose 3
    Feeling: Fair
    Adult check-in
  30. 2022-01-23
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  31. 2022-03-13
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  32. 2022-06-12
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  33. 2022-12-12
    Health check-in — 12 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-04-09Moderna
22021-05-07Moderna
32021-12-12Moderna No

Free text

Release 9 — 3 months, dose 2

2021-08-06

Symptoms: Fatigue, stomach issues

Release 10 — days 1–6 daily, dose 3

2021-12-14

Systemic reaction (other): Armpit soreness

2021-12-15

Systemic reaction (other): Armpit soreness

2021-12-16

Systemic reaction (other): Slight armpit soreness

2021-12-17

Systemic reaction (other): Mild armpit soreness

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

FieldPreferred term2021-092023-042024-11
SDFatigue ✓ · ✓
SDGastric disorder ✓ · ✓
SROAxillary pain · · ✓

✓ active code · ○ coded but marked inactive · blank = not in that release

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