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U4Y-20796-48894

3 vaccinations 4 coded responses 18 check-ins 4 free-text entries 2 call cases
Sex
Female
Age at first dose
36-40
ZIP prefix
622 / IL
Registered
2021-03-25
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-06
    Dose 1 — Moderna
  2. 2021-03-25
    Registered in v-safe
  3. 2021-03-25
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  4. 2021-03-29
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  5. 2021-04-03
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  6. 2021-04-07
    Dose 2 — Moderna
  7. 2021-04-10
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Nausea, Vomiting, Abdominal pain
    Adult check-in
  8. 2021-04-11
    Survey response — days 1–6 daily, dose 2
    MedDRA: Rash macular — Feeling: Good · Abdominal pain
    Free text: I have a large red blotchy area on the arm I got the injection but not where the injection was given.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-04-12
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Abdominal pain
    Adult check-in
  10. 2021-04-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  11. 2021-04-14
    Survey response — day 7, dose 2
    MedDRA: Fatigue, Insomnia — Feeling: Good · Fatigue or tiredness
    Free text: My 7 month old has been non stop nursing do I believe tiredness is related to a literal lack of sleep.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-04-21
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  13. 2021-04-28
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-05-05
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-05-12
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  16. 2021-05-19
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-07-07
    Survey response — 3 months, dose 2
    MedDRA: SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: My whole family got very sick a few weeks ago, vomiting, diarrhea, fevers, sore throats, etc. We got tested for COVID-19 as a precaution and everyone came back negative.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-07-07
    Report sent to call center — 3 months, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  19. 2021-07-12
  20. 2021-07-13
    Call successful
    Not applicable - Accidental Reporting
  21. 2021-10-06
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-11-27
    Dose 3 — Moderna
  23. 2022-04-07
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in
  24. 2022-05-30
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  25. 2022-11-27
    Survey response — 12 months, dose 3
    MedDRA: COVID-19, Illness — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: My family all had COVID, then followed by a barrage of other sicknesses (even rsv that was pretty rough for the adults).
    MedDRA releases: 2024-11 · check-in free text available
  26. 2022-11-27
    Report sent to call center — 12 months, dose 3
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · 1 call case(s)
  27. 2022-11-28
  28. 2022-11-28
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

DoseDateManufacturerCo-administered
12021-03-06Moderna
22021-04-07Moderna
32021-11-27Moderna No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-11

Systemic reaction (other): I have a large red blotchy area on the arm I got the injection but not where the injection was given.

Release 7 — day 7, dose 2

2021-04-14

Systemic reaction (other): My 7 month old has been non stop nursing do I believe tiredness is related to a literal lack of sleep.

Release 9 — 3 months, dose 2

2021-07-07

Symptoms: My whole family got very sick a few weeks ago, vomiting, diarrhea, fevers, sore throats, etc. We got tested for COVID-19 as a precaution and everyone came back negative.

Release 12 — 12 months, dose 3

2022-11-27

Symptoms: My family all had COVID, then followed by a barrage of other sicknesses (even rsv that was pretty rough for the adults).

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
SDCOVID-19 · · ✓
SDIllness · · ✓
SDSARS-CoV-2 test negative ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROInsomnia ✓ ✓ ✓
SRORash macular ✓ ✓ ✓

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