SMF-20477-26063
2 vaccinations
2 coded responses
18 check-ins
2 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 322 / FL
- Registered
- 2021-01-06
- Relationship
- Self
Timeline
-
2021-01-06
Registered in v-safe
-
2021-01-06
Dose 1 — Moderna
- 2021-01-06
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-11
-
2021-01-12
Survey response — days 1–6 daily, dose 1MedDRA: Pre-existing disease — Feeling: GoodFree text: FYI, i am a double transplant patient. Very immunosuppressedMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-13
- 2021-01-21
- 2021-01-27
-
2021-02-03
Dose 2 — Moderna
- 2021-02-03
-
2021-02-04
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-02-05
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-09
- 2021-02-10
-
2021-02-17
Survey response — day 14, dose 2MedDRA: Death, Emergency care, SARS-CoV-2 test negative — Feeling: PoorFree text: This is her oldest son. My mom passed away suddenly and unexpectedly 2/16/21 but did test negative with a rapid test in the ER.(b)(6) if some one wants to inquire further.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-06 | Moderna | |
| 2 | 2021-02-03 | Moderna |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): FYI, i am a double transplant patient. Very immunosuppressed
Release 4 — day 14, dose 2
Reports this person's death
Symptoms: This is her oldest son. My mom passed away suddenly and unexpectedly 2/16/21 but did test negative with a rapid test in the ER.(b)(6) if some one wants to inquire further.
redacted (b)(6)
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 | Death | ✓ | ✓ | ✓ |
| SD | Emergency care | ✓ | ✓ | ✓ |
| SD | SARS-CoV-2 test negative | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release