YXX-17684-59770
4 vaccinations
5 coded responses
43 check-ins
5 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 841 / UT
- Registered
- 2020-12-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
NRD-14634-69247
Child or adolescent in my care · Female · 2022-06-25
Timeline
-
2020-12-29
Registered in v-safe
-
2020-12-29
Dose 1 — Moderna
- 2020-12-29
- 2020-12-30
-
2020-12-31
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-01-01
- 2021-01-02
- 2021-01-03
- 2021-01-04
- 2021-01-06
- 2021-01-14
- 2021-01-19
-
2021-01-26
Dose 2 — Moderna
- 2021-01-26
-
2021-01-27
Survey response — days 1–6 daily, dose 2MedDRA: Self-medication — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tirednessFree text: Sx much improved with tylenolMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-28
- 2021-01-29
- 2021-01-31
- 2021-02-01
- 2021-02-02
- 2021-02-09
- 2021-02-16
- 2021-02-23
- 2021-03-02
- 2021-03-09
- 2021-04-27
- 2021-07-27
-
2021-10-22
Dose 3 — Moderna
-
2021-10-23
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Muscle or body achesAdult check-in
- 2021-10-24
- 2021-10-25
- 2021-10-26
- 2021-10-28
- 2021-10-29
-
2021-11-05
Survey response — day 14, dose 3MedDRA: Bronchitis, Laryngitis, SARS-CoV-2 test negative — Feeling: PoorFree text: Laryngitis and bronchitis. Tested neg for COVID x2MedDRA releases: 2024-11 · check-in free text available
- 2021-11-14
-
2021-11-19
Survey response — day 28, dose 3MedDRA: Pregnancy — Feeling: GoodFree text: Pregnant!MedDRA releases: 2024-11 · check-in free text available
- 2021-11-26
- 2021-12-03
- 2022-01-21
- 2022-04-22
-
2022-06-06
Dose 4 — Moderna
- 2022-06-25
-
2022-06-27
Survey response — day 21, dose 4MedDRA: SARS-CoV-2 test negative, Upper respiratory tract infection — Feeling: FairFree text: URI, tested neg for COVIDMedDRA releases: 2024-11 · check-in free text available
-
2022-07-04
Survey response — day 28, dose 4MedDRA: Sinusitis — Feeling: FairFree text: Sinus infectionMedDRA releases: 2024-11 · check-in free text available
- 2022-07-11
- 2022-07-18
- 2022-09-05
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2020-12-29 | Moderna | |
| 2 | 2021-01-26 | Moderna | |
| 3 | 2021-10-22 | Moderna | No |
| 4 | 2022-06-06 | Moderna | No |
Free text
Release 2 — days 1–6 daily, dose 2
Systemic reaction (other): Sx much improved with tylenol
Release 10 — day 14, dose 3
Symptoms: Laryngitis and bronchitis. Tested neg for COVID x2
Release 10 — day 28, dose 3
Symptoms: Pregnant!
Release 12 — day 21, dose 4
Symptoms: URI, tested neg for COVID
Release 12 — day 28, dose 4
Symptoms: Sinus infection
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 | Bronchitis | · | · | ✓ |
| SD | Laryngitis | · | · | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Sinusitis | · | · | ✓ |
| SD | Upper respiratory tract infection | · | · | ✓ |
| SRO | Self-medication | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release