MBV-33304-48208
4 vaccinations
6 coded responses
39 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 430 / OH
- Registered
- 2021-01-06
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Registered dependents
SQE-31896-57522
Child or adolescent in my care · Female · 2021-11-09
Timeline
-
2020-12-28
Dose 1 — Moderna
-
2021-01-06
Registered in v-safe
-
2021-01-06
Survey response — day 7, dose 1MedDRA: Injection site pain — Feeling: GoodFree text: Had arm pain on site of shot on 12/28-29, nothing else, it was mild, didnt take anything for itMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-11
- 2021-01-18
-
2021-01-25
Dose 2 — Moderna
- 2021-01-25
-
2021-01-26
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2021-01-27
Survey response — days 1–6 daily, dose 2MedDRA: Nausea, Pyrexia — Feeling: Good · Site: Pain · Headache, Fatigue or tirednessFree text: Some nausea and felt feverish late last night, took tylenol and slept better- today noneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-08
- 2021-02-15
- 2021-02-22
- 2021-03-01
- 2021-03-08
- 2021-04-26
- 2021-07-28
-
2021-10-28
Dose 3 — Moderna
- 2021-10-28
-
2021-10-29
Survey response — days 1–6 daily, dose 3MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tirednessFree text: Got booster dose*MedDRA releases: 2024-11 · check-in free text available
-
2021-10-30
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-10-31
Survey response — days 1–6 daily, dose 3MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good · Muscle or body achesFree text: Axillary Lymph node swelling since yesterday on arm of injection, with mild pain, today betterMedDRA releases: 2024-11 · check-in free text available
-
2021-11-01
Survey response — days 1–6 daily, dose 3MedDRA: Lymphadenopathy — Feeling: Good · Site: ItchingFree text: Mild (much decreased) swelling of axillary lymph nodesMedDRA releases: 2024-11 · check-in free text available
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-11
- 2021-11-18
- 2021-11-25
- 2021-12-02
- 2021-12-09
-
2022-04-28
Survey response — 6 months, dose 3MedDRA: Conjunctivitis, Nasopharyngitis — Feeling: GoodFree text: Had a cold once, covid negative and later left eye conjunctivitisMedDRA releases: 2024-11 · check-in free text available
-
2022-09-13
Dose 4 — Moderna
- 2022-09-29
- 2022-10-04
- 2022-10-11
- 2022-10-18
- 2022-10-25
- 2022-12-13
- 2023-03-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-28 | Moderna | |
| 2 | 2021-01-25 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
| 4 | 2022-09-13 | Moderna | No |
Free text
Release 1 — day 7, dose 1
Systemic reaction (other): Had arm pain on site of shot on 12/28-29, nothing else, it was mild, didnt take anything for it
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Some nausea and felt feverish late last night, took tylenol and slept better- today none
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Got booster dose*
Systemic reaction (other): Axillary Lymph node swelling since yesterday on arm of injection, with mild pain, today better
Systemic reaction (other): Mild (much decreased) swelling of axillary lymph nodes
Release 11 — 6 months, dose 3
Symptoms: Had a cold once, covid negative and later left eye conjunctivitis
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 | Conjunctivitis | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Lymph node pain | · | · | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release