QXN-14056-64401
4 vaccinations
3 coded responses
29 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 857 / AZ
- Registered
- 2021-12-07
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-19
Dose 1 — Moderna
-
2021-02-12
Dose 2 — Moderna
-
2021-12-07
Registered in v-safe
-
2021-12-07
Dose 3 — Moderna
-
2021-12-07
Health check-in — day 0, dose 3Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tirednessAdult check-in
-
2021-12-08
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
-
2021-12-09
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Redness, Swelling · ChillsAdult check-in
-
2021-12-10
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain, Swelling · Rash, not including the immediate area around the injection siteAdult check-in
- 2021-12-11
- 2021-12-12
- 2021-12-14
- 2021-12-21
- 2021-12-28
-
2022-01-04
Survey response — day 28, dose 3MedDRA: Dyspnoea — Feeling: GoodFree text: Difficulty breathingMedDRA releases: 2024-11 · check-in free text available
-
2022-01-11
Survey response — day 35, dose 3MedDRA: Nasal congestion, Oropharyngeal pain — Feeling: FairFree text: Stuffy nose, sore throat.MedDRA releases: 2024-11 · check-in free text available
-
2022-01-18
Survey response — day 42, dose 3MedDRA: COVID-19, Pregnancy, Urinary tract infection — 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 · Outpatient clinic or urgent care clinic visitFree text: #NAME?MedDRA releases: 2024-11 · check-in free text available
-
2022-01-18
Report sent to call center — day 42, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-01-20
-
2022-01-26
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-03-08
- 2022-06-07
-
2022-10-05
Dose 4 — Moderna
- 2022-10-05
-
2022-10-06
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-10-07
- 2022-10-08
- 2022-10-09
- 2022-10-10
- 2022-10-11
- 2022-10-12
- 2022-10-19
- 2022-10-26
- 2022-11-04
- 2022-11-09
- 2022-11-16
- 2023-01-04
- 2023-04-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-19 | Moderna | No |
| 2 | 2021-02-12 | Moderna | No |
| 3 | 2021-12-07 | Moderna | No |
| 4 | 2022-10-05 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 10 — day 28, dose 3
Symptoms: Difficulty breathing
Release 10 — day 35, dose 3
Symptoms: Stuffy nose, sore throat.
Release 10 — day 42, dose 3
Symptoms: #NAME?
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 | Dyspnoea | · | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SD | Urinary tract infection | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release