Y26-26529-47803
5 vaccinations
4 coded responses
65 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 547 / WI
- Registered
- 2021-02-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-02-04
Registered in v-safe
-
2021-02-04
Dose 1 — Moderna
- 2021-02-04
- 2021-02-05
- 2021-02-06
- 2021-02-07
- 2021-02-09
- 2021-02-10
- 2021-02-11
- 2021-02-18
- 2021-02-25
-
2021-03-04
Dose 2 — Moderna
- 2021-03-04
-
2021-03-05
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
-
2021-03-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, NauseaAdult check-in
- 2021-03-07
-
2021-03-08
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body achesAdult check-in
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-18
-
2021-03-25
Survey response — day 21, dose 2MedDRA: Nausea — Feeling: FairFree text: Ive had slight bit of nauseous feeling since the day I got the shot but its been very light but I have to admit that I have had a little love it every day since that 2nd shot. I stopped commenting on it Might be from something elseMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-01
- 2021-04-08
- 2021-04-15
- 2021-06-03
- 2021-09-02
-
2021-11-16
Dose 3 — Moderna
- 2021-11-16
-
2021-11-17
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, NauseaAdult check-in
- 2021-11-18
- 2021-11-19
- 2021-11-20
- 2021-11-21
- 2021-11-22
- 2021-11-23
- 2021-11-30
- 2021-12-07
- 2021-12-14
- 2021-12-21
- 2021-12-28
- 2022-02-15
-
2022-04-11
Dose 4 — Moderna
- 2022-04-11
-
2022-04-12
Health check-in — days 1–6 daily, dose 4Feeling: Poor · Site: Pain, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
-
2022-04-13
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-04-14
- 2022-04-16
- 2022-04-17
- 2022-04-18
- 2022-04-25
- 2022-05-02
- 2022-05-09
- 2022-05-16
- 2022-05-23
- 2022-07-11
- 2022-10-10
-
2022-11-05
Dose 5 — Moderna
- 2022-11-05
-
2022-11-06
Survey response — days 1–6 daily, dose 5MedDRA: Eye pain — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaFree text: My eyes acheMedDRA releases: 2024-11 · check-in free text available
-
2022-11-07
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain · Fatigue or tiredness, NauseaAdult check-in
-
2022-11-10
Survey response — days 1–6 daily, dose 5MedDRA: Cervical vertebral fracture, Contusion, Dizziness, Fall, Skin laceration — Feeling: Poor · Site: Pain, Itching · Headache, NauseaFree text: Due to dizziness From the booster shot I fell down a flight of steps in the basement and broke my neck in three places and have cuts and bruises on my face. I strongly feel this is part of the boosters dizziness effect. I just want you to know thatMedDRA releases: 2024-11 · check-in free text available
-
2022-11-11
Survey response — days 1–6 daily, dose 5MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, NauseaFree text: DizzinessMedDRA releases: 2024-11 · check-in free text available
- 2022-11-12
- 2022-11-19
- 2022-11-26
- 2022-12-03
- 2022-12-10
- 2022-12-17
- 2023-02-04
- 2023-05-06
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-04 | Moderna | |
| 2 | 2021-03-04 | Moderna | |
| 3 | 2021-11-16 | Moderna | No |
| 4 | 2022-04-11 | Moderna | No |
| 5 | 2022-11-05 | Moderna | No |
Free text
Release 6 — day 21, dose 2
Symptoms: Ive had slight bit of nauseous feeling since the day I got the shot but its been very light but I have to admit that I have had a little love it every day since that 2nd shot. I stopped commenting on it Might be from something else
Release 12 — days 1–6 daily, dose 5
Systemic reaction (other): My eyes ache
Systemic reaction (other): Due to dizziness From the booster shot I fell down a flight of steps in the basement and broke my neck in three places and have cuts and bruises on my face. I strongly feel this is part of the boosters dizziness effect. I just want you to know that cut off by CDC
Systemic reaction (other): Dizziness
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 | Nausea | ✓ | ✓ | ✓ |
| SRO | Cervical vertebral fracture | · | · | ✓ |
| SRO | Contusion | · | · | ✓ |
| SRO | Dizziness | · | · | ✓ |
| SRO | Eye pain | · | · | ✓ |
| SRO | Fall | · | · | ✓ |
| SRO | Skin laceration | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release