Z4F-11511-07940
4 vaccinations
6 coded responses
20 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 469 / IN
- Registered
- 2021-01-24
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-23
Dose 1 — Moderna
-
2021-01-24
Registered in v-safe
- 2021-01-24
-
2021-01-26
Survey response — days 1–6 daily, dose 1MedDRA: Arthralgia, Headache — Feeling: Good · Site: Pain, Swelling, Itching · Headache, Joint painsFree text: I don't know if headache and joint pain are related to vaccination or just other age related problemsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-27
- 2021-01-29
-
2021-02-01
Survey response — day 7, dose 1MedDRA: Dyspnoea — Feeling: Fair · Headache, Joint pains · Be unable to do your normal daily activitiesFree text: Breathing is somewhat more difficult.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-08
Survey response — day 14, dose 1MedDRA: Injection site discolouration, Injection site swelling — Feeling: GoodFree text: I have an area about the size of a goose egg at the injection site that slightly puffy and discolored. The area does not itch nor is it painful.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-20
Dose 2 — Moderna
-
2021-02-23
Survey response — days 1–6 daily, dose 2MedDRA: Ear discomfort — Feeling: Good · Site: Redness, Swelling, Itching · Headache, NauseaFree text: Ears feel like they have water in themMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-24
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Redness, Swelling, Itching · Joint pains, Muscle or body achesAdult check-in
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2021-02-25
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Itching · Headache, Joint painsAdult check-in
-
2021-02-26
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-02-27
- 2021-03-06
-
2021-03-13
Survey response — day 21, dose 2MedDRA: Headache — Feeling: Fair · Be unable to do your normal daily activitiesFree text: I have had a headache for the last several days that I can't seem to get rid of. I do not know if it is related to my Moderna VaccineMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-20
- 2021-03-27
-
2021-04-03
Survey response — day 42, dose 2MedDRA: Chronic obstructive pulmonary disease, Condition aggravated, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activitiesFree text: I am having more problems with my COPD requiring a more frequent use of the nebulizer. I do not suffer from seasonal allergies.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-22
- 2021-08-21
-
2021-11-09
Dose 3 — Moderna
-
2022-10-13
Dose 4 — ModernaCo-administered: Flu
- 2022-11-09
- 2022-11-09
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-23 | Moderna | |
| 2 | 2021-02-20 | Moderna | |
| 3 | 2021-11-09 | Moderna | No |
| 4 | 2022-10-13 | Moderna | Flu |
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): I don't know if headache and joint pain are related to vaccination or just other age related problems
Release 3 — day 7, dose 1
Systemic reaction (other): Breathing is somewhat more difficult.
Release 3 — day 14, dose 1
Symptoms: I have an area about the size of a goose egg at the injection site that slightly puffy and discolored. The area does not itch nor is it painful.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Ears feel like they have water in them
Release 5 — day 21, dose 2
Symptoms: I have had a headache for the last several days that I can't seem to get rid of. I do not know if it is related to my Moderna Vaccine
Release 6 — day 42, dose 2
Symptoms: I am having more problems with my COPD requiring a more frequent use of the nebulizer. I do not suffer from seasonal allergies.
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 | Chronic obstructive pulmonary disease | ✓ | ✓ | ✓ |
| SD | Condition aggravated | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Injection site discolouration | ✓ | ✓ | ✓ |
| SD | Injection site swelling | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Arthralgia | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Ear discomfort | ✓ | ✓ | ✓ |
| SRO | Headache | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release