LPK-28686-49811
2 vaccinations
2 coded responses
24 check-ins
2 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 770 / TX
- Registered
- 2021-03-03
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-03
Registered in v-safe
-
2021-03-03
Dose 1 — Moderna
- 2021-03-03
- 2021-03-04
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-12
- 2021-03-17
-
2021-03-26
Survey response — day 21, dose 1MedDRA: Chills, Headache — Feeling: FairFree text: Headache & chillsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-31
Dose 2 — Moderna
- 2021-03-31
- 2021-04-01
- 2021-04-02
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-14
- 2021-04-21
- 2021-04-28
- 2021-05-05
- 2021-05-14
- 2021-06-30
- 2021-09-29
-
2022-03-31
Survey response — 12 months, dose 2MedDRA: Heart rate increased, Joint swelling, Office visit, Paraesthesia, Pyrexia, Rash — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visitFree text: Symptoms: Fever of 103, pins and needles on right side of cheeck & right side of tongue. Rash on right hand, swollen ankles, & rapid heat beat when walking upstairs. · Healthcare visit (other): Follow up doctor visit with pcpMedDRA releases: 2024-11 · check-in free text available
-
2022-03-31
Report sent to call center — 12 months, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
-
2022-04-04
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-03 | Moderna | |
| 2 | 2021-03-31 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 6 — day 21, dose 1
Symptoms: Headache & chills
Release 11 — 12 months, dose 2
Symptoms: Fever of 103, pins and needles on right side of cheeck & right side of tongue. Rash on right hand, swollen ankles, & rapid heat beat when walking upstairs.
Healthcare visit (other): Follow up doctor visit with pcp
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 | Office visit | · | · | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Heart rate increased | · | · | ✓ |
| SD | Joint swelling | · | · | ✓ |
| SD | Paraesthesia | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rash | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release