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MVX-67303-91480

4 vaccinations 5 coded responses 12 check-ins 5 free-text entries 0 call cases
Sex
Female
Age at first dose
31-35
ZIP prefix
105 / NY
Registered
2021-03-10
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
5J8-26380-82625 Child or adolescent in my care · Male · 2022-12-28

Timeline

  1. 2021-02-24
    Dose 1 — Moderna
  2. 2021-03-10
    Registered in v-safe
  3. 2021-03-10
    Survey response — day 14, dose 1
    MedDRA: Erythema — Feeling: Fair
    Free text: My arm (Same side i got the vaccine) has red dots that look like blood clots
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-18
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  5. 2021-03-24
    Dose 2 — Moderna
  6. 2021-03-24
    Health check-in — day 0, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  7. 2021-03-26
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities
    Adult check-in
  8. 2021-03-29
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  9. 2021-04-09
    Survey response — day 14, dose 2
    MedDRA: Arthralgia, Back pain — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Hip and back pain
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-04-23
    Health check-in — day 28, dose 2
    Feeling: Poor
    Adult check-in
  11. 2021-09-25
    Survey response — 6 months, dose 2
    MedDRA: Pregnancy — Feeling: Good · Be unable to do your normal daily activities
    Free text: 3 months Pregnant
    MedDRA releases: 2024-11 · check-in free text available
  12. 2021-10-28
    Dose 3 — Moderna
  13. 2021-10-29
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness
    Adult check-in
  14. 2021-11-01
    Survey response — days 1–6 daily, dose 3
    MedDRA: Dizziness — Feeling: Fair · Site: Swelling · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Free text: dizzy spell
    MedDRA releases: 2024-11 · check-in free text available
  15. 2021-11-03
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Fatigue or tiredness
    Adult check-in
  16. 2022-09-29
    Dose 4 — Moderna
  17. 2022-12-29
    Survey response — 3 months, dose 4
    MedDRA: COVID-19 — Feeling: Fair · Be unable to work or attend school
    Free text: COVID
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-02-24Moderna
22021-03-24Moderna
32021-10-28Moderna No
42022-09-29Moderna No

Free text

Release 5 — day 14, dose 1

2021-03-10

Symptoms: My arm (Same side i got the vaccine) has red dots that look like blood clots

Release 7 — day 14, dose 2

2021-04-09

Symptoms: Hip and back pain

Release 9 — 6 months, dose 2

2021-09-25

Symptoms: 3 months Pregnant

Release 10 — days 1–6 daily, dose 3

2021-11-01

Systemic reaction (other): dizzy spell

Release 12 — 3 months, dose 4

2022-12-29

Symptoms: 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

FieldPreferred term2021-092023-042024-11
SDArthralgia ✓ ✓ ✓
SDBack pain ✓ ✓ ✓
SDCOVID-19 · · ✓
SDErythema ✓ ✓ ✓
SDPregnancy · · ✓
SRODizziness · · ✓

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