U3V-17563-03129
4 vaccinations
3 coded responses
44 check-ins
3 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 570 / SD
- Registered
- 2021-04-08
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
6L6-66092-63518
Child or adolescent in my care · Female · 2022-06-28
Timeline
-
2021-04-07
Dose 1 — Moderna
-
2021-04-08
Registered in v-safe
- 2021-04-08
- 2021-04-09
- 2021-04-10
- 2021-04-11
- 2021-04-12
- 2021-04-13
- 2021-04-14
- 2021-04-21
-
2021-04-28
Survey response — day 21, dose 1MedDRA: Asthenopia, Headache, Neck pain — Feeling: FairFree text: Multiple headaches in the past few days. Eye strain and neck pain.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-05
Dose 2 — Moderna
- 2021-05-05
-
2021-05-06
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-05-07
- 2021-05-08
- 2021-05-09
- 2021-05-10
- 2021-05-11
- 2021-05-12
- 2021-05-19
- 2021-05-26
- 2021-06-02
- 2021-06-10
-
2021-06-16
Survey response — day 42, dose 2MedDRA: Abdominal distension, Asthenia, Diarrhoea, Flatulence, Gastroenteritis viral — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Currently have a stomach bug- diarrhea, bloating, gas, loss of energy.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-08-04
- 2021-11-03
-
2021-11-22
Dose 3 — Moderna
-
2021-11-22
Health check-in — day 0, dose 3Feeling: Good · Site: Pain · Headache, Muscle or body achesAdult check-in
-
2021-11-23
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
-
2021-11-24
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Headache, Muscle or body achesAdult check-in
- 2021-11-25
- 2021-11-26
- 2021-11-27
- 2021-11-28
- 2021-11-29
- 2021-12-06
- 2021-12-13
- 2021-12-20
-
2021-12-27
Survey response — day 35, dose 3MedDRA: Paranasal sinus hypersecretion — Feeling: GoodFree text: Sinus drainageMedDRA releases: 2024-11 · check-in free text available
- 2022-01-03
- 2022-02-21
- 2022-05-25
-
2022-11-18
Dose 4 — Pfizer-BioNTech
- 2022-12-12
- 2022-12-16
- 2022-12-23
- 2022-12-30
- 2023-05-19
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-07 | Moderna | |
| 2 | 2021-05-05 | Moderna | |
| 3 | 2021-11-22 | Moderna | No |
| 4 | 2022-11-18 | Pfizer-BioNTech | No |
Free text
Release 8 — day 21, dose 1
Symptoms: Multiple headaches in the past few days. Eye strain and neck pain.
Release 9 — day 42, dose 2
Symptoms: Currently have a stomach bug- diarrhea, bloating, gas, loss of energy.
Release 10 — day 35, dose 3
Symptoms: Sinus drainage
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 | Abdominal distension | ✓ | ✓ | ✓ |
| SD | Asthenia | ✓ | ✓ | ✓ |
| SD | Asthenopia | ✓ | ✓ | ✓ |
| SD | Diarrhoea | ✓ | ✓ | ✓ |
| SD | Flatulence | ✓ | ✓ | ✓ |
| SD | Gastroenteritis viral | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Neck pain | ✓ | ✓ | ✓ |
| SD | Paranasal sinus hypersecretion | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release