UL5-27370-08236
4 vaccinations
1 coded response
39 check-ins
1 free-text entry
0 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 479 / IN
- Registered
- 2021-04-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
28S-14423-30728
Child or adolescent in my care · Female · 2022-06-22
Timeline
-
2021-04-16
Registered in v-safe
-
2021-04-16
Dose 1 — Moderna
-
2021-04-16
Health check-in — day 0, dose 1Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-17
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
-
2021-04-18
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-04-19
- 2021-04-20
- 2021-04-21
- 2021-04-22
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-05-14
-
2021-05-20
Dose 2 — Moderna
-
2021-05-20
Health check-in — day 0, dose 2Feeling: Good · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-05-21
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Fatigue or tiredness, Abdominal painAdult check-in
-
2021-05-22
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Fatigue or tirednessAdult check-in
-
2021-05-23
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Chills, HeadacheAdult check-in
- 2021-05-24
- 2021-05-25
- 2021-05-26
- 2021-05-27
- 2021-06-03
- 2021-06-10
- 2021-06-17
- 2021-06-24
- 2021-07-01
-
2021-08-19
Survey response — 3 months, dose 2MedDRA: Hallucination, visual — Feeling: GoodFree text: Visual hallucinationsMedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-11-18
-
2021-12-28
Dose 3 — Moderna
- 2022-06-28
-
2022-10-29
Dose 4 — Pfizer-BioNTech
- 2022-10-30
-
2022-10-31
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2022-11-01
- 2022-11-02
- 2022-11-03
- 2022-11-04
- 2022-11-07
- 2022-11-12
- 2022-11-19
- 2022-11-26
- 2022-12-06
- 2022-12-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-16 | Moderna | |
| 2 | 2021-05-20 | Moderna | |
| 3 | 2021-12-28 | Moderna | No |
| 4 | 2022-10-29 | Pfizer-BioNTech | No |
Free text
Release 9 — 3 months, dose 2
Symptoms: Visual hallucinations
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 | Hallucination, visual | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release