XY6-68204-16850
2 vaccinations
3 coded responses
23 check-ins
3 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 958 / CA
- Registered
- 2021-01-18
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-17
Dose 1 — Moderna
-
2021-01-18
Registered in v-safe
-
2021-01-18
Survey response — days 1–6 daily, dose 1MedDRA: Dizziness — Feeling: Good · Site: PainMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-01-19
-
2021-01-21
Health check-in — days 1–6 daily, dose 1Feeling: Good · Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-01-22
- 2021-01-24
-
2021-01-31
Survey response — 14 day, dose 1MedDRA: Loss of consciousness — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-02-07
-
2021-02-14
Dose 2 — Moderna
- 2021-02-14
-
2021-02-15
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-16
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea, DiarrheaAdult check-in
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-28
-
2021-03-07
Survey response — 21 day, dose 2MedDRA: Fungal infection, Headache, Tenderness — Feeling: Fair · Be unable to workMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-03-14
- 2021-03-21
- 2021-03-28
- 2021-05-16
- 2021-08-15
- 2022-02-14
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-17 | Moderna | |
| 2 | 2021-02-14 | Moderna |
Free text
Release 2
Systemic reaction (other): Slightly woosey this am
Release 3
Symptoms: After a vision test Friday, with numbing drops & dilation drops, I came home & I was completely knocked out for about 4 hours. I do not remember this happening before with a vision appt. Wondered if it was in addition to my vaccine being on board
Release 5
Symptoms: I have had a slightly tender stomach. And I dont think that they are related to my test, but I have had a couple of severe headaches & I developed a yeast infection. They are new since the last check in but I attribute them to other circumstances.
Free-text releases are not linked to a specific 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 | Fungal infection | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Loss of consciousness | ✓ | ✓ | ✓ |
| SD | Tenderness | ✓ | ✓ | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release