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XYH-67916-63545

2 vaccinations 5 coded responses 18 check-ins 5 free-text entries 0 call cases
Sex
Female
Age at first dose
12-15
ZIP prefix
967 / HI
Registered
2021-10-11
Relationship
Child or adolescent in my care
Guardian
KK6-18330-39437
Race
Multiracial
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-10-11
    Registered in v-safe
  2. 2021-10-11
    Dose 1 — Moderna
  3. 2021-10-11
    Health check-in — day 0, dose 1, dependent
    Feeling: Good · Site: Pain · Fatigue or tiredness, Nausea
    Adult check-in
  4. 2021-10-12
    Health check-in — days 1–6 daily, dose 1, dependent
    Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches
    Adult check-in
  5. 2021-10-13
    Health check-in — days 1–6 daily, dose 1, dependent
    Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches
    Adult check-in
  6. 2021-10-15
    Health check-in — days 1–6 daily, dose 1, dependent
    Feeling: Good · None
    Adult check-in
  7. 2021-10-16
    Health check-in — days 1–6 daily, dose 1, dependent
    Feeling: Fair · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  8. 2021-10-17
    Survey response — days 1–6 daily, dose 1, dependent
    MedDRA: Dizziness, Dysstasia — Feeling: Good · Be unable to do your normal daily activities
    Free text: Dizzy and wonky when standing
    MedDRA releases: 2024-11 · check-in free text available
  9. 2021-10-20
    Health check-in — day 7, dose 1, dependent
    Feeling: Good · None
    Adult check-in
  10. 2021-10-25
    Survey response — day 14, dose 1, dependent
    MedDRA: Vaccination site pain — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Pain in arm where vaccine was given.
    MedDRA releases: 2024-11 · check-in free text available
  11. 2021-11-01
    Survey response — day 21, dose 1, dependent
    MedDRA: Pain in extremity — Feeling: Fair
    Free text: Arm soreness
    MedDRA releases: 2024-11 · check-in free text available
  12. 2021-11-09
    Dose 2 — Pfizer-BioNTech
  13. 2021-11-10
    Health check-in — days 1–6 daily, dose 2, dependent
    Feeling: Poor · Site: Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities
    Adult check-in
  14. 2021-11-12
    Health check-in — days 1–6 daily, dose 2, dependent
    Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  15. 2021-11-13
    Health check-in — days 1–6 daily, dose 2, dependent
    Feeling: Fair · None
    Adult check-in
  16. 2021-11-14
    Health check-in — days 1–6 daily, dose 2, dependent
    Feeling: Good · None
    Adult check-in
  17. 2021-11-16
    Health check-in — day 7, dose 2, dependent
    Feeling: Fair · None
    Adult check-in
  18. 2021-11-23
    Health check-in — day 14, dose 2, dependent
    Feeling: Good
    Adult check-in
  19. 2021-11-30
    Survey response — day 21, dose 2, dependent
    MedDRA: Chest pain, Fatigue, Irritability, Mass, Neck mass — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Lumps in legs, knee, nape of neck. Tired, grouchy, chest pain.
    MedDRA releases: 2024-11 · check-in free text available
  20. 2021-12-09
    Survey response — day 28, dose 2, dependent
    MedDRA: Arthralgia, Mass, Pain — Feeling: Fair · Be unable to work or attend school
    Free text: Body aches joints and lumps
    MedDRA releases: 2024-11 · check-in free text available
  21. 2022-02-08

Vaccinations

DoseDateManufacturerCo-administered
12021-10-11Moderna No
22021-11-09Pfizer-BioNTech No

Free text

Release 10 — days 1–6 daily, dose 1, dependent

2021-10-17

Systemic reaction (other): Dizzy and wonky when standing

Release 10 — day 14, dose 1, dependent

2021-10-25

Symptoms: Pain in arm where vaccine was given.

Release 10 — day 21, dose 1, dependent

2021-11-01

Symptoms: Arm soreness

Release 10 — day 21, dose 2, dependent

2021-11-30

Symptoms: Lumps in legs, knee, nape of neck. Tired, grouchy, chest pain.

Release 10 — day 28, dose 2, dependent

2021-12-09

Symptoms: Body aches joints and lumps

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
SDArthralgia · · ✓
SDChest pain · · ✓
SDFatigue · · ✓
SDIrritability · · ✓
SDMass · · ✓
SDNeck mass · · ✓
SDPain · · ✓
SDPain in extremity · · ✓
SDVaccination site pain · · ✓
SRODizziness · · ✓
SRODysstasia · · ✓

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