GJ5-79502-01981
3 vaccinations
8 coded responses
26 check-ins
8 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 921 / CA
- Registered
- 2020-12-24
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2020-12-24
Registered in v-safe
-
2020-12-24
Dose 1 — Moderna
- 2020-12-24
- 2020-12-25
- 2020-12-26
-
2020-12-27
Survey response — days 1–6 daily, dose 1MedDRA: Abdominal pain — Feeling: Good · Abdominal painFree text: Had abd pain last night that started after the check in, but might have also been related to something I ate for lunchMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2020-12-28
- 2020-12-29
- 2020-12-30
- 2020-12-31
- 2021-01-07
-
2021-01-14
Survey response — day 21, dose 1MedDRA: Headache — Feeling: GoodFree text: Mild headache 2 days ago, didnt take any medsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-19
Dose 2 — Moderna
-
2021-01-21
Survey response — days 1–6 daily, dose 2MedDRA: Rash — Feeling: Good · Site: Pain · Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection siteFree text: Rash on R shoulder I think related to carrying heavy bag (received vaccine on L side)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-22
Survey response — days 1–6 daily, dose 2MedDRA: Headache — Feeling: Good · Site: Pain · HeadacheFree text: Headache more likely related to work stress todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-01-23
Survey response — days 1–6 daily, dose 2MedDRA: Headache — Feeling: Good · HeadacheFree text: Headache was residual from yesterday, improved after taking acetaminophenMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-24
Survey response — days 1–6 daily, dose 2MedDRA: Injection site discolouration — Feeling: GoodFree text: Headache resolved. Have some yellow skin around injection site, but no more pain, no swellingMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-25
- 2021-01-26
- 2021-02-02
- 2021-02-09
- 2021-02-16
- 2021-02-23
- 2021-03-03
- 2021-04-20
-
2021-07-20
Survey response — 6 months, dose 2MedDRA: Nasopharyngitis, SARS-CoV-2 test negative, Supportive care — Feeling: Good · Be unable to work or attend schoolFree text: Had cold sx 6/14-15 but COVID test was negative, just stayed home w supportive careMedDRA releases: 2024-11 · check-in free text available
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2021-11-12
Dose 3 — Moderna
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2022-01-19
Survey response — 12 months, dose 2MedDRA: Back pain, COVID-19, Headache, Pregnancy, SARS-CoV-2 test positive, Unevaluable event — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visitFree text: Symptoms: Headache, backache; recovering from COVID (positive test 1/11). Received booster Nov 2021 (not sure if in your records). Am also now 9 weeks pregnant · Healthcare visit (other): Received monoclonal antibodiesMedDRA releases: 2024-11 · check-in free text available
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2022-01-19
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
-
2022-01-22
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-05-13
- 2022-11-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-24 | Moderna | |
| 2 | 2021-01-19 | Moderna | |
| 3 | 2021-11-12 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Had abd pain last night that started after the check in, but might have also been related to something I ate for lunch
Release 2 — day 21, dose 1
Symptoms: Mild headache 2 days ago, didnt take any meds
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Rash on R shoulder I think related to carrying heavy bag (received vaccine on L side)
Systemic reaction (other): Headache more likely related to work stress today
Systemic reaction (other): Headache was residual from yesterday, improved after taking acetaminophen
Systemic reaction (other): Headache resolved. Have some yellow skin around injection site, but no more pain, no swelling
Release 9 — 6 months, dose 2
Symptoms: Had cold sx 6/14-15 but COVID test was negative, just stayed home w supportive care
Release 10 — 12 months, dose 2
Symptoms: Headache, backache; recovering from COVID (positive test 1/11). Received booster Nov 2021 (not sure if in your records). Am also now 9 weeks pregnant
Healthcare visit (other): Received monoclonal antibodies
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 |
|---|---|---|---|---|
| HCVO | Unevaluable event | · | · | ✓ |
| SD | Back pain | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Supportive care | · | · | ✓ |
| SRO | Abdominal pain | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Injection site discolouration | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release