PEK-66194-26864
2 vaccinations
4 coded responses
19 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 104 / NY
- Registered
- 2021-09-10
- Relationship
- Self
- Race
- Black or African American
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-09-10
Registered in v-safe
-
2021-09-10
Dose 1 — Moderna
- 2021-09-10
- 2021-09-11
-
2021-09-12
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-09-13
-
2021-09-14
Survey response — days 1–6 daily, dose 1MedDRA: Peripheral swelling — Feeling: GoodFree text: Slight swelling of my hands but it went awayMedDRA releases: 2024-11 · check-in free text available
- 2021-09-15
- 2021-09-16
- 2021-09-17
- 2021-09-24
- 2021-10-01
-
2021-10-08
Dose 2 — Moderna
- 2021-10-15
- 2021-10-22
- 2021-10-29
- 2021-11-05
-
2021-11-12
Survey response — day 35, dose 2MedDRA: Menstruation delayed — Feeling: GoodFree text: I have not gotten my period yet. It's three days late.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-21
-
2022-01-07
Survey response — 3 months, dose 2MedDRA: Nasal congestion, Sinus headache — Feeling: Good · Be unable to do your normal daily activitiesFree text: Nose is stuffy. Sinus headacheMedDRA releases: 2024-11 · check-in free text available
- 2022-04-08
-
2022-10-08
Survey response — 12 months, dose 2MedDRA: COVID-19 — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: I have CovidMedDRA releases: 2024-11 · check-in free text available
-
2022-10-08
Report sent to call center — 12 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · 1 call case(s)
-
2022-10-10
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-09-10 | Moderna | No |
| 2 | 2021-10-08 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 9 — days 1–6 daily, dose 1
Systemic reaction (other): Slight swelling of my hands but it went away
Release 10 — day 35, dose 2
Symptoms: I have not gotten my period yet. It's three days late.
Release 10 — 3 months, dose 2
Symptoms: Nose is stuffy. Sinus headache
Release 12 — 12 months, dose 2
Symptoms: I have 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 | COVID-19 | · | · | ✓ |
| SD | Menstruation delayed | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Sinus headache | · | · | ✓ |
| SRO | Peripheral swelling | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release