NGB-21053-63465
4 vaccinations
3 coded responses
25 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 971 / OR
- Registered
- 2021-02-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
KCA-91071-89488
Child or adolescent in my care · Male · 2021-11-20
A63-28120-72356
Adult relative or friend · Male · 2022-05-26
Timeline
-
2021-01-29
Dose 1 — Moderna
-
2021-02-26
Registered in v-safe
-
2021-02-26
Dose 2 — Moderna
- 2021-02-26
-
2021-02-27
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-27
Report sent to call center — days 1–6 daily, dose 2Be unable to do your normal daily activities1 call case(s)
- 2021-02-28
- 2021-03-01
-
2021-03-03
Survey response — days 1–6 daily, dose 2MedDRA: Injection site pain — Feeling: Good · Site: Pain · Muscle or body achesFree text: Only extremely minor site pain if I press on itMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-04
- 2021-03-07
-
2021-03-12
Survey response — day 14, dose 2MedDRA: Pruritus, Rash, Rash pruritic — Feeling: GoodFree text: Not sure it's covered related but I've had some bumps on the inside of my elbow this week that we're itchy but are going away this is the same arm as I had my second shot vaccine. Other than this minor minor nothing.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-19
- 2021-03-26
- 2021-04-03
- 2021-04-09
- 2021-05-29
- 2021-08-27
-
2021-10-28
Dose 3 — ModernaCo-administered: Flu
-
2021-11-20
Survey response — day 21, dose 3MedDRA: Feeling abnormal — Feeling: GoodFree text: The following day I didn't feel great but it was pretty minor after the booster shotMedDRA releases: 2024-11 · check-in free text available
- 2021-11-27
- 2022-01-29
-
2022-04-21
Dose 4 — Moderna
- 2022-04-30
- 2022-05-16
- 2022-05-21
- 2022-05-26
- 2022-06-02
- 2022-07-26
- 2022-10-21
- 2023-04-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-29 | Moderna | |
| 2 | 2021-02-26 | Moderna | |
| 3 | 2021-10-28 | Moderna | Flu |
| 4 | 2022-04-21 | Moderna | No |
Call center
1 call center case
1 priority 2/3 (triaged and no follow up)
Free text
Release 5 — days 1–6 daily, dose 2
Systemic reaction (other): Only extremely minor site pain if I press on it
Release 5 — day 14, dose 2
Symptoms: Not sure it's covered related but I've had some bumps on the inside of my elbow this week that we're itchy but are going away this is the same arm as I had my second shot vaccine. Other than this minor minor nothing.
Release 10 — day 21, dose 3
Symptoms: The following day I didn't feel great but it was pretty minor after the booster shot
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 | Feeling abnormal | · | · | ✓ |
| SD | Pruritus | ✓ | ✓ | ○ |
| SD | Rash | · | · | ✓ |
| SD | Rash pruritic | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release