Y5X-12652-58591
4 vaccinations
7 coded responses
48 check-ins
7 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 328 / FL
- Registered
- 2021-04-15
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-15
Registered in v-safe
-
2021-04-15
Dose 1 — Moderna
- 2021-04-15
-
2021-04-16
Survey response — days 1–6 daily, dose 1MedDRA: Pain — Feeling: Fair · Site: PainFree text: More sore than last nightMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-17
- 2021-04-18
- 2021-04-19
- 2021-04-20
-
2021-04-21
Survey response — days 1–6 daily, dose 1MedDRA: Erythema, Pruritus, Self-medication — Feeling: GoodFree text: I have been having skin issue on my neck and bit my face (it was itchy last week) but I want sure if it came from eating seafoods by accident warier last week. I took some allergy medicine and putting Benadryl, now putting fresh aloe Vera.) its not itching anymore but still looks little redMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-22
Survey response — day 7, dose 1MedDRA: Pruritus — Feeling: GoodFree text: My neck area is still slightly itchy but not badMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-29
- 2021-05-06
-
2021-05-13
Dose 2 — Moderna
- 2021-05-13
-
2021-05-14
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
-
2021-05-15
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to workAdult check-in
-
2021-05-16
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-05-17
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain, Swelling · Fatigue or tirednessAdult check-in
- 2021-05-18
- 2021-05-19
- 2021-05-20
- 2021-05-27
- 2021-06-04
- 2021-06-10
- 2021-06-17
-
2021-06-24
Survey response — day 42, dose 2MedDRA: Constipation, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Constipation, was diagnosed for colon cancer. (Its nothing to do COVID-19)MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-08-12
Survey response — 3 months, dose 2MedDRA: Colectomy — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Symptoms are from post surgery which I had on 7/23. ColectomyMedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-11-11
-
2021-11-15
Dose 3 — Moderna
- 2021-11-15
-
2021-11-16
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Swelling · Chills, Headache, Fatigue or tiredness · Be unable to work or attend schoolAdult check-in
-
2021-11-17
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Swelling · Fatigue or tirednessAdult check-in
-
2021-11-18
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Swelling · Fatigue or tirednessAdult check-in
- 2021-11-19
- 2021-11-20
- 2021-11-21
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2021-12-13
- 2021-12-20
- 2021-12-27
- 2022-02-14
-
2022-05-03
Dose 4 — ModernaCo-administered: Shingles
-
2022-05-16
Survey response — 6 months, dose 3MedDRA: Fatigue, Pyrexia — Feeling: Good · Be unable to work or attend schoolFree text: Right after the 2nd booster shots I was fatigued, feverish. But now I am okMedDRA releases: 2024-11 · check-in free text available
-
2022-05-19
Survey response — day 14, dose 4MedDRA: Fatigue, Malaise, Pyrexia — Feeling: Good · Be unable to do your normal daily activitiesFree text: Right after the vaccine, I wasn't feeling good for two days. Fatigue, some feverMedDRA releases: 2024-11 · check-in free text available
- 2022-05-24
- 2022-05-31
- 2022-06-07
- 2022-06-14
- 2022-08-02
- 2022-11-01
- 2023-05-03
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-15 | Moderna | |
| 2 | 2021-05-13 | Moderna | |
| 3 | 2021-11-15 | Moderna | No |
| 4 | 2022-05-03 | Moderna | Shingles |
Free text
Release 7 — days 1–6 daily, dose 1
Systemic reaction (other): More sore than last night
Systemic reaction (other): I have been having skin issue on my neck and bit my face (it was itchy last week) but I want sure if it came from eating seafoods by accident warier last week. I took some allergy medicine and putting Benadryl, now putting fresh aloe Vera.) its not itching anymore but still looks little red
Release 7 — day 7, dose 1
Systemic reaction (other): My neck area is still slightly itchy but not bad
Release 9 — day 42, dose 2
Symptoms: Constipation, was diagnosed for colon cancer. (Its nothing to do COVID-19)
Release 9 — 3 months, dose 2
Symptoms: Symptoms are from post surgery which I had on 7/23. Colectomy
Release 11 — 6 months, dose 3
Symptoms: Right after the 2nd booster shots I was fatigued, feverish. But now I am ok
Release 11 — day 14, dose 4
Symptoms: Right after the vaccine, I wasn't feeling good for two days. Fatigue, some fever
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 | Colectomy | ✓ | · | ✓ |
| SD | Constipation | ✓ | ✓ | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Malaise | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SRO | Erythema | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release