SRV-11152-34868
4 vaccinations
5 coded responses
48 check-ins
4 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 190 / PA
- Registered
- 2021-01-25
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-25
Registered in v-safe
-
2021-01-25
Dose 1 — Moderna
- 2021-01-25
-
2021-01-26
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Headache, Muscle or body achesAdult check-in
- 2021-01-27
- 2021-01-28
- 2021-01-29
- 2021-01-30
- 2021-01-31
- 2021-02-01
- 2021-02-08
- 2021-02-17
- 2021-02-22
-
2021-03-01
Dose 2 — Moderna
- 2021-03-01
-
2021-03-02
Survey response — days 1–6 daily, dose 2MedDRA: Dizziness, Malaise — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness · Be unable to workFree text: Feel hung over, little dizzy cMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-03
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Fatigue or tiredness · Be unable to workAdult check-in
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-15
- 2021-03-22
- 2021-03-29
- 2021-04-05
-
2021-04-12
Survey response — day 42, dose 2MedDRA: Chills, Gastrointestinal disorder, Headache, Pain, Pyrexia, SARS-CoV-2 test — Feeling: Good · Be unable to work, 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: Symptoms: Last week I had a very bad headache, gastrointestinal problems, chills, fever, and body aches. I am fine now, as of April 12th. I was sick April 6-10. · Healthcare visit (other): Covid Rapid TestMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-12
Report sent to call center — day 42, dose 2Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-31
- 2021-09-01
-
2021-10-29
Dose 3 — ModernaCo-administered: Flu
- 2021-10-29
-
2021-10-31
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
- 2021-11-05
- 2021-11-12
- 2021-11-19
- 2021-11-28
- 2021-12-03
-
2021-12-10
Survey response — day 42, dose 3MedDRA: Oropharyngeal pain, Rhinorrhoea, Sinus congestion, Stridor — 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 · Telehealth, virtual health, or email health consultationFree text: Sinus congestion. Runny nose. Sore throat. Raspy breathing.MedDRA releases: 2024-11 · check-in free text available
-
2021-12-10
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 prTelehealth, virtual health, or email health consultation · 1 call case(s)
- 2021-12-13
-
2021-12-13
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-01-30
-
2022-04-13
Dose 4 — Moderna
-
2022-04-20
Health check-in — day 7, dose 4Feeling: Good · Site: Pain, Redness, Swelling, Itching · NoneAdult check-in
- 2022-04-27
- 2022-05-04
- 2022-05-11
- 2022-05-20
-
2022-05-27
Survey response — day 42, dose 4MedDRA: Concussion, Pre-existing disease — 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 · Outpatient clinic or urgent care clinic visitFree text: Pollen allergies, concussionMedDRA releases: 2024-11 · check-in free text available
-
2022-05-27
Report sent to call center — day 42, dose 4Be 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)
- 2022-05-31
-
2022-05-31
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2022-07-13
- 2022-10-12
-
2023-04-13
Survey response — 12 months, dose 4MedDRA: COVID-19 — Feeling: Good · 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 consultationMedDRA releases: 2024-11
-
2023-04-13
Report sent to call center — 12 months, dose 4Be 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)
-
2023-04-14
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 | 2021-01-25 | Moderna | |
| 2 | 2021-03-01 | Moderna | |
| 3 | 2021-10-29 | Moderna | Flu |
| 4 | 2022-04-13 | Moderna | No |
Call center
4 call center cases
4 successful
Free text
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Feel hung over, little dizzy c
Release 7 — day 42, dose 2
Symptoms: Last week I had a very bad headache, gastrointestinal problems, chills, fever, and body aches. I am fine now, as of April 12th. I was sick April 6-10.
Healthcare visit (other): Covid Rapid Test
Release 10 — day 42, dose 3
Symptoms: Sinus congestion. Runny nose. Sore throat. Raspy breathing.
Release 11 — day 42, dose 4
Symptoms: Pollen allergies, concussion
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 |
|---|---|---|---|---|
| HCVO | SARS-CoV-2 test | ✓ | ✓ | ✓ |
| SD | Chills | ✓ | ✓ | ✓ |
| SD | Concussion | · | · | ✓ |
| SD | COVID-19 | · | · | ✓ |
| SD | Gastrointestinal disorder | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Oropharyngeal pain | · | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | · | · | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SD | Stridor | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Malaise | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release