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TQM-30996-75611

3 vaccinations 3 coded responses 31 check-ins 3 free-text entries 0 call cases
Sex
Female
Age at first dose
46-50
ZIP prefix
275 / NC
Registered
2021-03-22
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino
Registered dependents
VVM-98146-69643 Child or adolescent in my care · Male · 2021-11-20

Timeline

  1. 2021-03-11
    Dose 1 — Moderna
  2. 2021-03-22
    Registered in v-safe
  3. 2021-03-22
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-03-26
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  5. 2021-04-01
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  6. 2021-04-08
    Dose 2 — Moderna
  7. 2021-04-08
    Health check-in — day 0, dose 2
    Feeling: Good · None
    Adult check-in
  8. 2021-04-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  9. 2021-04-11
    Survey response — days 1–6 daily, dose 2
    MedDRA: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth — Feeling: Fair · Site: Pain, Redness, Swelling · Headache
    Free text: Red tender swollen spot, hot to touch. Near injection site but further down my arm a little.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-04-12
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Redness, Swelling · None
    Adult check-in
  11. 2021-04-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  12. 2021-04-15
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  13. 2021-04-22
    Survey response — day 14, dose 2
    MedDRA: Headache — Feeling: Good
    Free text: Continuing headaches
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-05-06
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-05-13
    Survey response — day 35, dose 2
    MedDRA: Headache — Feeling: Good
    Free text: Frequent headaches
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-05-21
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in
  17. 2021-07-08
    Health check-in — 3 months, dose 2
    Feeling: Fair
    Adult check-in
  18. 2021-10-07
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-11-20
    Dose 3 — Moderna
  20. 2021-11-20
    Health check-in — day 0, dose 3
    Feeling: Fair · Site: Pain · Headache
    Adult check-in
  21. 2021-11-21
    Health check-in — days 1–6 daily, dose 3
    Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  22. 2021-11-22
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain · Headache, Muscle or body aches
    Adult check-in
  23. 2021-11-23
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  24. 2021-11-24
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  25. 2021-11-25
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  26. 2021-11-26
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Headache
    Adult check-in
  27. 2021-11-27
    Health check-in — day 7, dose 3
    Feeling: Fair · Headache · Be unable to do your normal daily activities
    Adult check-in
  28. 2021-12-04
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  29. 2021-12-11
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  30. 2021-12-18
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  31. 2021-12-26
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  32. 2022-01-01
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  33. 2022-02-19
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  34. 2022-05-22
    Health check-in — 6 months, dose 3
    Feeling: Fair
    Adult check-in
  35. 2022-11-20
    Health check-in — 12 months, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-11Moderna
22021-04-08Moderna
32021-11-20Moderna No

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-11

Systemic reaction (other): Red tender swollen spot, hot to touch. Near injection site but further down my arm a little.

Release 7 — day 14, dose 2

2021-04-22

Symptoms: Continuing headaches

Release 8 — day 35, dose 2

2021-05-13

Symptoms: Frequent headaches

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

FieldPreferred term2021-092023-042024-11
SDHeadache ✓ ✓ ✓
SROInjection site erythema ✓ ✓ ✓
SROInjection site pain ✓ ✓ ✓
SROInjection site swelling ✓ ✓ ✓
SROInjection site warmth ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release

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