Z58-15077-99555
5 vaccinations
4 coded responses
33 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 972 / OR
- Registered
- 2021-01-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-03
Dose 1 — Moderna
-
2021-01-04
Registered in v-safe
-
2021-01-04
Survey response — days 1–6 daily, dose 1MedDRA: Musculoskeletal stiffness, Pain in extremity — Feeling: GoodFree text: My left arm was somewhat stiff/sore when I first woke up. It loosened up fairly quickly.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-05
- 2021-01-06
- 2021-01-07
- 2021-01-08
- 2021-01-09
- 2021-01-10
- 2021-01-17
- 2021-01-24
-
2021-01-31
Dose 2 — Moderna
- 2021-01-31
-
2021-02-01
Survey response — days 1–6 daily, dose 2MedDRA: Diarrhoea — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body achesFree text: I had one loose stool that I would not classify as diarrhea.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-06
- 2021-02-07
- 2021-02-14
- 2021-02-21
- 2021-02-28
- 2021-03-07
- 2021-03-14
- 2021-05-02
- 2021-08-02
-
2021-11-07
Dose 3 — Moderna
- 2022-01-31
-
2022-04-15
Dose 4 — Moderna
-
2022-04-24
Survey response — day 7, dose 4MedDRA: Body temperature increased, Chills, Fatigue, Injection site pain, Pain — Feeling: GoodFree text: The day following my shot (each time) I experienced a mild sore arm around the injection site, and mild aches, chills and fatigue for 12-24 hours. I had a fever around 100 degrees after the last shot.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-29
- 2022-05-08
- 2022-05-13
- 2022-05-20
- 2022-05-27
- 2022-07-15
-
2022-10-13
Dose 5 — Moderna
-
2022-10-14
Survey response — 6 months, dose 4MedDRA: Pain, Reaction to previous exposure to any vaccine — Feeling: FairFree text: I had my third COVID booster (new one) late yesterday, and I have mild achiness, possibly low grade fever, etc. today. This is same reaction I've had after each dose/booster.MedDRA releases: 2024-11 · check-in free text available
- 2023-04-13
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-03 | Moderna | |
| 2 | 2021-01-31 | Moderna | |
| 3 | 2021-11-07 | Moderna | No |
| 4 | 2022-04-15 | Moderna | No |
| 5 | 2022-10-13 | Moderna | No |
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): My left arm was somewhat stiff/sore when I first woke up. It loosened up fairly quickly.
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): I had one loose stool that I would not classify as diarrhea.
Release 11 — day 7, dose 4
Systemic reaction (other): The day following my shot (each time) I experienced a mild sore arm around the injection site, and mild aches, chills and fatigue for 12-24 hours. I had a fever around 100 degrees after the last shot.
Release 12 — 6 months, dose 4
Symptoms: I had my third COVID booster (new one) late yesterday, and I have mild achiness, possibly low grade fever, etc. today. This is same reaction I've had after each dose/booster.
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 | Pain | · | · | ✓ |
| SD | Reaction to previous exposure to any vaccine | · | · | ✓ |
| SRO | Body temperature increased | · | · | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Diarrhoea | ✓ | ✓ | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Musculoskeletal stiffness | ✓ | ✓ | ✓ |
| SRO | Pain | · | · | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release