Y35-16173-50165
2 vaccinations
4 coded responses
22 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 761 / TX
- Registered
- 2021-01-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-01-03
Registered in v-safe
-
2021-01-03
Dose 1 — Moderna
- 2021-01-03
-
2021-01-04
Survey response — days 1–6 daily, dose 1MedDRA: Pain in extremity — Feeling: Good · Site: Pain · Muscle or body achesFree text: The pain in the arm was moderate last night but as this morning progressed and I was 24 Hr from vaccine shot the pain turned very mild. Only hurts if I push down on the area.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-06
- 2021-01-07
- 2021-01-08
-
2021-01-09
Survey response — days 1–6 daily, dose 1MedDRA: Irritability — Feeling: GoodFree text: I was very easily irritated on days 4 and 5 ( Wednesday & Thursday)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-10
- 2021-01-17
- 2021-01-24
-
2021-01-28
Dose 2 — Moderna
-
2021-01-31
Survey response — days 1–6 daily, dose 2MedDRA: Fatigue, Headache, Influenza like illness, Pain, Pyrexia — Feeling: Fair · Site: Itching · Chills, Headache, Joint pains · Be unable to do your normal daily activitiesFree text: Today I experienced a headache only and feel ok not great but not bad either. On Friday I experienced flu like symptoms. I felt feverish but my temperature was 99. I felt ache and tired.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-11
- 2021-02-18
- 2021-02-25
-
2021-03-04
Survey response — day 35, dose 2MedDRA: Hypertension, Pre-existing disease — Feeling: GoodFree text: Hypertension diagnosis.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-11
- 2021-04-29
- 2021-07-31
- 2022-01-28
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-03 | Moderna | |
| 2 | 2021-01-28 | Moderna |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): The pain in the arm was moderate last night but as this morning progressed and I was 24 Hr from vaccine shot the pain turned very mild. Only hurts if I push down on the area.
Systemic reaction (other): I was very easily irritated on days 4 and 5 ( Wednesday & Thursday)
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Today I experienced a headache only and feel ok not great but not bad either. On Friday I experienced flu like symptoms. I felt feverish but my temperature was 99. I felt ache and tired.
Release 5 — day 35, dose 2
Symptoms: Hypertension diagnosis.
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 | Hypertension | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Influenza like illness | ✓ | ✓ | ✓ |
| SRO | Irritability | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Pyrexia | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release