Y3R-16357-47881
5 vaccinations
6 coded responses
44 check-ins
5 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 863 / AZ
- Registered
- 2021-01-21
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-21
Registered in v-safe
-
2021-01-21
Dose 1 — Moderna
- 2021-01-21
- 2021-01-22
- 2021-01-23
- 2021-01-25
- 2021-01-26
- 2021-01-27
- 2021-01-28
- 2021-02-04
- 2021-02-11
-
2021-02-18
Dose 2 — Moderna
-
2021-02-18
Survey response — day 0, dose 2MedDRA: Nausea — Feeling: Fair · Site: Pain · Chills, HeadacheFree text: Queasy stomachMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-19
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
-
2021-02-20
Survey response — days 1–6 daily, dose 2MedDRA: Decreased appetite, Nausea — Feeling: GoodFree text: Slight queasiness, decreased appetiteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-02-24
- 2021-02-25
- 2021-03-05
- 2021-03-11
- 2021-03-18
- 2021-03-25
- 2021-04-03
-
2021-08-20
Survey response — 6 months, dose 2MedDRA: Abdominal discomfort, COVID-19, Dyspnoea, Headache, Oxygen saturation decreased, Productive cough, Self-medication — Feeling: Good · Be unable to do your normal daily activitiesFree text: 1 1/2 weeks : GI distress 1 day, followed by 1 day odd headache, followed by a week of productive cough, lower O2 sat of 90, mild sob. No temp elevation.Treated w ibuprofen, guiafenesin. Resolved , no apparent residual effects. Suspect covid.MedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-10-23
Dose 3 — Moderna
-
2021-10-25
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activitiesAdult check-in
- 2021-10-26
- 2021-10-27
- 2021-10-28
- 2021-10-30
- 2021-11-07
- 2021-11-13
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2022-01-25
-
2022-05-19
Dose 4 — Moderna
- 2022-06-22
- 2022-06-23
- 2022-07-02
- 2022-08-20
-
2022-10-10
Dose 5 — Moderna
- 2022-11-02
- 2022-11-08
-
2022-11-16
Survey response — day 35, dose 5MedDRA: Fatigue, Nasal congestion, Nasopharyngitis — Feeling: Good · Be unable to do your normal daily activitiesFree text: Bad head cold w nasal congestion & fatigue 3 daysMedDRA releases: 2024-11 · check-in free text available
-
2022-11-23
Survey response — day 42, dose 5MedDRA: Body temperature increased, Cough, Fatigue, Nasal congestion, Nasopharyngitis, Pain — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Bad cold! Cough, body aches, nasal congestion, fatigu, elevated temp x 3 days, possible rsv exposureMedDRA releases: 2024-11 · check-in free text available
-
2023-01-14
Survey response — 3 months, dose 5MedDRA: Neck pain, Vertigo — Feeling: Good · Be unable to do your normal daily activitiesMedDRA releases: 2024-11
- 2023-04-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-21 | Moderna | |
| 2 | 2021-02-18 | Moderna | |
| 3 | 2021-10-23 | Moderna | No |
| 4 | 2022-05-19 | Moderna | No |
| 5 | 2022-10-10 | Moderna | No |
Free text
Release 4 — day 0, dose 2
Systemic reaction (other): Queasy stomach
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Slight queasiness, decreased appetite
Release 9 — 6 months, dose 2
Symptoms: 1 1/2 weeks : GI distress 1 day, followed by 1 day odd headache, followed by a week of productive cough, lower O2 sat of 90, mild sob. No temp elevation.Treated w ibuprofen, guiafenesin. Resolved , no apparent residual effects. Suspect covid.
Release 12 — day 35, dose 5
Symptoms: Bad head cold w nasal congestion & fatigue 3 days
Release 12 — day 42, dose 5
Symptoms: Bad cold! Cough, body aches, nasal congestion, fatigu, elevated temp x 3 days, possible rsv exposure
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 | Abdominal discomfort | ✓ | · | ✓ |
| SD | Body temperature increased | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | COVID-19 | ✓ | · | ✓ |
| SD | Dyspnoea | ✓ | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | ✓ | · | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Neck pain | · | · | ✓ |
| SD | Oxygen saturation decreased | ✓ | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Productive cough | ✓ | · | ✓ |
| SD | Self-medication | ✓ | · | ✓ |
| SD | Vertigo | · | · | ✓ |
| SRO | Decreased appetite | ✓ | ✓ | ✓ |
| SRO | Nausea | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release