Z4Y-19194-93136
3 vaccinations
5 coded responses
37 check-ins
5 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 531 / WI
- Registered
- 2021-04-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
8J4-11182-81011
Child or adolescent in my care · Male · 2021-11-23
4EY-26022-06190
Child or adolescent in my care · Male · 2021-11-23
X39-38385-42902
Child or adolescent in my care · Female · 2021-11-23
PXX-62327-87826
Child or adolescent in my care · Male · 2021-11-23
Timeline
-
2021-04-20
Registered in v-safe
-
2021-04-20
Dose 1 — Moderna
- 2021-04-20
-
2021-04-21
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Fatigue or tirednessAdult check-in
- 2021-04-22
- 2021-04-23
- 2021-04-24
- 2021-04-25
- 2021-04-26
- 2021-04-27
- 2021-05-04
- 2021-05-11
-
2021-05-18
Dose 2 — Moderna
- 2021-05-18
-
2021-05-19
Survey response — days 1–6 daily, dose 2MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: These symptoms may also be because of the start of my menstrual period today, or made worse by that.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-20
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2021-05-21
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2021-05-22
- 2021-05-23
- 2021-05-24
- 2021-05-25
- 2021-06-01
-
2021-06-08
Survey response — day 21, dose 2MedDRA: Oropharyngeal pain, Pre-existing disease — Feeling: GoodFree text: Sore throat, only lasting 2 days, possibly related to seasonal allergies.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-15
- 2021-06-22
-
2021-06-29
Survey response — day 42, dose 2MedDRA: Fatigue, Oropharyngeal pain, Pain — Feeling: GoodFree text: Brief viral illness? Less than 24 hours of sore throat, body aches, and fatigue.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-08-17
- 2021-11-16
-
2021-12-13
Dose 3 — Moderna
-
2021-12-15
Survey response — days 1–6 daily, dose 3MedDRA: Fatigue, Headache, Myalgia, Pain, Self-medication — Feeling: Good · Site: PainFree text: I experienced mild muscle/body aches, fatigue, and headache yesterday, Dec 14, but forgot to complete the health check in. All symptoms were mild and resolved easily with otc pain medication.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-18
- 2021-12-19
- 2021-12-20
- 2021-12-27
- 2022-01-03
-
2022-01-10
Survey response — day 28, dose 3MedDRA: Fatigue, Headache, Nasopharyngitis, Oropharyngeal pain, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Minor cold symptoms, sore throat, congestion, fatigue and headache.MedDRA releases: 2024-11 · check-in free text available
- 2022-01-18
- 2022-01-24
- 2022-03-15
- 2022-06-13
- 2022-12-15
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-20 | Moderna | |
| 2 | 2021-05-18 | Moderna | |
| 3 | 2021-12-13 | Moderna | No |
Free text
Release 8 — days 1–6 daily, dose 2
Systemic reaction (other): These symptoms may also be because of the start of my menstrual period today, or made worse by that.
Release 8 — day 21, dose 2
Symptoms: Sore throat, only lasting 2 days, possibly related to seasonal allergies.
Release 9 — day 42, dose 2
Symptoms: Brief viral illness? Less than 24 hours of sore throat, body aches, and fatigue.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): I experienced mild muscle/body aches, fatigue, and headache yesterday, Dec 14, but forgot to complete the health check in. All symptoms were mild and resolved easily with otc pain medication.
Release 10 — day 28, dose 3
Symptoms: Minor cold symptoms, sore throat, congestion, fatigue and headache.
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 | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | Myalgia | · | · | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Self-medication | · | · | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release