Z2Y-22504-69130
5 vaccinations
3 coded responses
51 check-ins
2 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 905 / CA
- Registered
- 2021-03-07
- Relationship
- Self
- Race
- Asian
- Ethnicity
- Not Hispanic or Latino
Registered dependents
FNK-22330-25333
Child or adolescent in my care · Male · 2022-06-26
Timeline
-
2021-03-05
Dose 1 — Moderna
-
2021-03-07
Registered in v-safe
- 2021-03-07
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-12
- 2021-03-19
- 2021-03-26
- 2021-04-02
-
2021-04-05
Dose 2 — Moderna
- 2021-04-05
-
2021-04-06
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, NauseaAdult check-in
- 2021-04-07
-
2021-04-08
Survey response — days 1–6 daily, dose 2MedDRA: Dehydration — Feeling: Fair · Headache, Fatigue or tirednessFree text: DehydrationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-09
Survey response — days 1–6 daily, dose 2MedDRA: Dehydration — Feeling: Fair · Headache, Fatigue or tirednessFree text: DehydrationMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-10
- 2021-04-11
- 2021-04-12
- 2021-04-19
- 2021-04-26
- 2021-05-03
- 2021-05-10
- 2021-05-17
- 2021-07-07
- 2021-10-06
-
2021-11-19
Dose 3 — Moderna
- 2022-04-05
-
2022-04-30
Dose 4 — Moderna
- 2022-04-30
- 2022-05-01
- 2022-05-02
- 2022-05-04
- 2022-05-05
- 2022-05-06
- 2022-05-07
- 2022-05-14
- 2022-05-21
- 2022-05-28
- 2022-06-04
- 2022-06-11
- 2022-07-30
-
2022-10-21
Dose 5 — Moderna
- 2022-10-22
- 2022-10-23
- 2022-10-24
- 2022-10-25
- 2022-10-26
- 2022-10-27
- 2022-10-28
- 2022-11-04
- 2022-11-11
- 2022-11-18
- 2022-11-25
- 2022-12-02
-
2023-01-22
Survey response — 3 months, dose 5MedDRA: Cough, Respiratory syncytial virus infection, Respiratory tract congestion, Rhinorrhoea, Sinus congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesMedDRA releases: 2024-11
- 2023-04-23
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-05 | Moderna | |
| 2 | 2021-04-05 | Moderna | |
| 3 | 2021-11-19 | Moderna | No |
| 4 | 2022-04-30 | Moderna | No |
| 5 | 2022-10-21 | Moderna | No |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Dehydration
Systemic reaction (other): Dehydration
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 | Cough | · | · | ✓ |
| SD | Respiratory syncytial virus infection | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SRO | Dehydration | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release