MF7-17864-14733
4 vaccinations
5 coded responses
34 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 911 / CA
- Registered
- 2021-01-21
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Registered dependents
JJS-27019-07022
Child or adolescent in my care · Male · 2022-08-10
Timeline
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2021-01-12
Dose 1 — Moderna
-
2021-01-21
Registered in v-safe
- 2021-01-21
- 2021-01-26
- 2021-02-02
-
2021-02-09
Survey response — day 28, dose 1MedDRA: Contusion, Head injury, Headache — Feeling: FairFree text: Light Bruise under right eye and headacheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-12
Dose 2 — Moderna
-
2021-02-13
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
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2021-02-14
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2021-02-15
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-02-16
-
2021-02-17
Survey response — days 1–6 daily, dose 2MedDRA: Stomatitis — Feeling: GoodFree text: Raw palate. (Mouth) - may be unrelated to vaccine but thought I should report itMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-18
Survey response — days 1–6 daily, dose 2MedDRA: Palatal swelling, Stomatitis — Feeling: GoodFree text: Improving raw/swelling of upper palate of mouth. Again, not sure if this is related to the vaccine.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-19
- 2021-02-26
- 2021-03-05
- 2021-03-12
- 2021-03-21
- 2021-03-26
- 2021-05-15
- 2021-08-13
-
2021-11-15
Dose 3 — Moderna
-
2022-02-12
Survey response — 12 months, dose 2MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Got COVIDMedDRA releases: 2024-11 · check-in free text available
-
2022-10-06
Dose 4 — Pfizer-BioNTech
- 2022-10-06
- 2022-10-07
- 2022-10-08
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2022-10-09
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2022-10-10
- 2022-10-11
- 2022-10-12
- 2022-10-13
- 2022-10-22
- 2022-10-27
- 2022-11-03
- 2022-11-10
- 2022-11-17
-
2023-01-05
Survey response — 3 months, dose 4MedDRA: Delivery — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, HospitalizationMedDRA releases: 2024-11
-
2023-01-05
Report sent to call center — 3 months, dose 4Be unable to work or attend school · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
- 2023-01-06
- 2023-04-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-12 | Moderna | |
| 2 | 2021-02-12 | Moderna | |
| 3 | 2021-11-15 | Moderna | No |
| 4 | 2022-10-06 | Pfizer-BioNTech | No |
Call center
1 call center case
1 unsuccessful
Free text
Release 3 — day 28, dose 1
Symptoms: Light Bruise under right eye and headache
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Raw palate. (Mouth) - may be unrelated to vaccine but thought I should report it
Systemic reaction (other): Improving raw/swelling of upper palate of mouth. Again, not sure if this is related to the vaccine.
Release 11 — 12 months, dose 2
Symptoms: Got COVID
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 | Contusion | ✓ | ✓ | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Delivery | · | · | ✓ |
| SD | Head injury | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SRO | Palatal swelling | ✓ | ✓ | ✓ |
| SRO | Stomatitis | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release