U8J-16897-43304
3 vaccinations
4 coded responses
39 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 986 / WA
- Registered
- 2021-01-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
2YE-31544-03085
Child or adolescent in my care · Male · 2021-11-25
Timeline
-
2021-01-14
Registered in v-safe
-
2021-01-14
Dose 1 — Moderna
- 2021-01-14
- 2021-01-15
-
2021-01-16
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain, Paranasal sinus discomfort, Pre-existing disease — Feeling: Good · Site: PainFree text: Pain at injection site very mild- had some sinus pressure today but It felt like pressure was being released. Take Zyrtec daily for seasonal allergiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-01-17
Survey response — days 1–6 daily, dose 1MedDRA: Injection site pain — Feeling: GoodFree text: Only a bit tender on top of injection site. Does not hurt to sleep on left side /arm and it doesnt her to raise my arm anymore.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-18
- 2021-01-19
- 2021-01-21
- 2021-01-28
- 2021-02-04
- 2021-02-12
-
2021-02-16
Dose 2 — Moderna
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-03-16
- 2021-03-23
- 2021-03-30
- 2021-05-18
- 2021-08-17
-
2021-10-28
Dose 3 — Moderna
- 2021-10-28
-
2021-10-29
Survey response — days 1–6 daily, dose 3MedDRA: Impaired work ability, Self-medication, Somnolence — Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to work or attend schoolFree text: Yesterday evening about 3 to 4 hrs after the shot- fell alseep for about an hours. Couldn't keep my eyes open. Stayed hydrated and took 1000mg of Tylenol before bedtime. I did stay home from work to rest and take it easy. Took an afternoon nap.MedDRA releases: 2024-11 · check-in free text available
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
- 2021-11-03
- 2021-11-04
-
2021-11-13
Survey response — day 14, dose 3MedDRA: Vomiting — Feeling: GoodFree text: I think it is pregnancy related. Threw up 2 nights but no other symptoms and I was able to keep water and other food down. switch back to bland foods. Last two days have been better.MedDRA releases: 2024-11 · check-in free text available
- 2021-11-18
- 2021-11-25
- 2021-12-02
- 2022-04-30
- 2022-10-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-14 | Moderna | |
| 2 | 2021-02-16 | Moderna | |
| 3 | 2021-10-28 | Moderna | No |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): Pain at injection site very mild- had some sinus pressure today but It felt like pressure was being released. Take Zyrtec daily for seasonal allergies
Systemic reaction (other): Only a bit tender on top of injection site. Does not hurt to sleep on left side /arm and it doesnt her to raise my arm anymore.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Yesterday evening about 3 to 4 hrs after the shot- fell alseep for about an hours. Couldn't keep my eyes open. Stayed hydrated and took 1000mg of Tylenol before bedtime. I did stay home from work to rest and take it easy. Took an afternoon nap.
Release 10 — day 14, dose 3
Symptoms: I think it is pregnancy related. Threw up 2 nights but no other symptoms and I was able to keep water and other food down. switch back to bland foods. Last two days have been better.
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 | Vomiting | · | · | ✓ |
| SRO | Impaired work ability | · | · | ✓ |
| SRO | Injection site pain | ✓ | ✓ | ✓ |
| SRO | Paranasal sinus discomfort | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Self-medication | · | · | ✓ |
| SRO | Somnolence | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release