N83-30178-40146
3 vaccinations
4 coded responses
29 check-ins
4 free-text entries
2 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 540 / WI
- Registered
- 2021-03-31
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-31
Registered in v-safe
-
2021-03-31
Dose 1 — Moderna
- 2021-03-31
-
2021-04-01
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
-
2021-04-02
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain, Redness, Swelling · NoneAdult check-in
- 2021-04-04
-
2021-04-05
Health check-in — days 1–6 daily, dose 1Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
-
2021-04-06
Health check-in — days 1–6 daily, dose 1Feeling: Good · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-04-09
- 2021-04-14
- 2021-04-21
- 2021-04-28
-
2021-04-29
Dose 2 — Moderna
- 2021-05-05
- 2021-05-06
- 2021-05-13
- 2021-05-22
- 2021-05-27
- 2021-06-03
-
2021-06-10
Survey response — day 42, dose 2MedDRA: Dizziness, Headache — Feeling: FairFree text: Dizziness and light headachesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-29
-
2021-10-28
Survey response — 6 months, dose 2MedDRA: Appendicitis perforated — Feeling: Good · 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 visit, HospitalizationFree text: Ruptured appendixMedDRA releases: 2024-11 · check-in free text available
-
2021-10-28
Report sent to call center — 6 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 · Hospitalization · 1 call case(s)
- 2021-10-29
-
2021-11-05
Dose 3 — Moderna
- 2021-11-11
- 2021-11-12
-
2021-11-19
Survey response — day 14, dose 3MedDRA: Migraine — Feeling: Fair · Be unable to do your normal daily activitiesFree text: MigraineMedDRA releases: 2024-11 · check-in free text available
- 2021-11-26
- 2021-12-03
- 2021-12-10
- 2021-12-17
-
2022-02-04
Survey response — 3 months, dose 3MedDRA: COVID-19, Fatigue, Headache, Nasopharyngitis — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Covid-fairly mild. Headache, cold symptoms, exhaustionMedDRA releases: 2024-11 · check-in free text available
-
2022-02-04
Report sent to call center — 3 months, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2022-02-08
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-05-06
- 2022-11-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-31 | Moderna | |
| 2 | 2021-04-29 | Moderna | |
| 3 | 2021-11-05 | Moderna | No |
Call center
2 call center cases
2 successful
Free text
Release 9 — day 42, dose 2
Symptoms: Dizziness and light headaches
Release 10 — 6 months, dose 2
Symptoms: Ruptured appendix
Release 10 — day 14, dose 3
Symptoms: Migraine
Release 11 — 3 months, dose 3
Symptoms: Covid-fairly mild. Headache, cold symptoms, exhaustion
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 | Appendicitis perforated | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Migraine | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release