YJS-15216-75961
4 vaccinations
9 coded responses
41 check-ins
9 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 801 / CO
- Registered
- 2021-03-26
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-17
Dose 1 — Moderna
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2021-03-26
Registered in v-safe
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2021-03-26
Survey response — day 7, dose 1MedDRA: Headache — Feeling: Poor · Site: Pain, Itching · Headache, Fatigue or tiredness · Be unable to workFree text: Headache lasting since March 18thMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-31
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2021-04-07
Survey response — day 21, dose 1MedDRA: Breast pain — Feeling: GoodFree text: Headache wrnt away but left breast has been sore and painful. I had vaccine in left arm. I had normal mammogram just prior to vaccination.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-14
Dose 2 — Moderna
- 2021-04-14
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2021-04-15
Survey response — days 1–6 daily, dose 2MedDRA: Dysgeusia, Vaccine positive rechallenge — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to workFree text: Metallic taste and food tastes off...this occurred with first one as well.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-16
Survey response — days 1–6 daily, dose 2MedDRA: Dysgeusia — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Fatigue or tiredness, DiarrheaFree text: Metalic tasteMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-17
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain, Swelling, Itching · NoneAdult check-in
- 2021-04-19
- 2021-04-20
- 2021-04-21
- 2021-04-28
- 2021-05-05
- 2021-05-12
- 2021-05-19
- 2021-05-26
- 2021-07-14
- 2021-10-13
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2021-11-12
Dose 3 — Moderna
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2021-11-18
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Fatigue or tirednessAdult check-in
- 2021-11-19
- 2021-11-26
- 2021-12-03
- 2021-12-10
- 2021-12-17
- 2021-12-24
- 2022-02-11
- 2022-05-13
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2022-07-25
Dose 4 — Pfizer-BioNTech
- 2022-07-25
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2022-07-26
Survey response — days 1–6 daily, dose 4MedDRA: Gingival swelling, Office visit, Periodontal operation, Procedural site reaction — Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tirednessFree text: Confurmed with dental surgeon, peridobtal surgery site swelled up 2 to 3 x normal the evening after shot...only 1 week out from surgeryMedDRA releases: 2024-11 · check-in free text available
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2022-07-27
Survey response — days 1–6 daily, dose 4MedDRA: Headache, Periodontal operation, Post procedural swelling, Procedural pain — Feeling: Fair · Site: Pain · Fever · HeadacheFree text: Peridontal surgery site us super swollen and painful still and headache has increasedMedDRA releases: 2024-11 · check-in free text available
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2022-07-28
Survey response — days 1–6 daily, dose 4MedDRA: Periodontal operation, Swelling — Feeling: Fair · HeadacheFree text: Peridontal surgery site still swollenMedDRA releases: 2024-11 · check-in free text available
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2022-07-29
Survey response — days 1–6 daily, dose 4MedDRA: Periodontal operation, Post procedural swelling, Suture related complication — Feeling: Fair · HeadacheFree text: Swelling in peridontal area started to recede hiwever surgeon said it broke several sutures and now I need even more surgical intervention.MedDRA releases: 2024-11 · check-in free text available
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2022-07-30
Survey response — days 1–6 daily, dose 4MedDRA: Insomnia, Nausea — Feeling: Fair · Headache, Fatigue or tiredness, NauseaFree text: Unable to sleep last two nights sick to stomacheMedDRA releases: 2024-11 · check-in free text available
- 2022-07-31
- 2022-08-01
- 2022-08-08
- 2022-08-15
- 2022-08-22
- 2022-08-29
- 2022-09-05
- 2022-10-24
- 2023-01-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-17 | Moderna | |
| 2 | 2021-04-14 | Moderna | |
| 3 | 2021-11-12 | Moderna | No |
| 4 | 2022-07-25 | Pfizer-BioNTech | No |
Free text
Release 6 — day 7, dose 1
Systemic reaction (other): Headache lasting since March 18th
Release 7 — day 21, dose 1
Symptoms: Headache wrnt away but left breast has been sore and painful. I had vaccine in left arm. I had normal mammogram just prior to vaccination.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Metallic taste and food tastes off...this occurred with first one as well.
Systemic reaction (other): Metalic taste
Release 12 — days 1–6 daily, dose 4
Systemic reaction (other): Confurmed with dental surgeon, peridobtal surgery site swelled up 2 to 3 x normal the evening after shot...only 1 week out from surgery
Systemic reaction (other): Peridontal surgery site us super swollen and painful still and headache has increased
Systemic reaction (other): Peridontal surgery site still swollen
Systemic reaction (other): Swelling in peridontal area started to recede hiwever surgeon said it broke several sutures and now I need even more surgical intervention.
Systemic reaction (other): Unable to sleep last two nights sick to stomache
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 | Breast pain | ✓ | ✓ | ✓ |
| SRO | Dysgeusia | ✓ | ✓ | ✓ |
| SRO | Gingival swelling | · | · | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
| SRO | Insomnia | · | · | ✓ |
| SRO | Nausea | · | · | ✓ |
| SRO | Office visit | · | · | ✓ |
| SRO | Periodontal operation | · | · | ✓ |
| SRO | Post procedural swelling | · | · | ✓ |
| SRO | Procedural pain | · | · | ✓ |
| SRO | Procedural site reaction | · | · | ✓ |
| SRO | Suture related complication | · | · | ✓ |
| SRO | Swelling | · | · | ✓ |
| SRO | Vaccine positive rechallenge | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release