Z5D-13766-40458
4 vaccinations
4 coded responses
39 check-ins
3 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 633 / MO
- Registered
- 2021-03-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
QRV-22578-86150
Child or adolescent in my care · Female · 2022-06-23
Timeline
-
2021-03-13
Dose 1 — Moderna
-
2021-03-14
Registered in v-safe
-
2021-03-14
Survey response — days 1–6 daily, dose 1MedDRA: Night sweats — Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tirednessFree text: Night sweats overnightMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-15
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Fever · Fatigue or tirednessAdult check-in
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-19
- 2021-03-20
- 2021-03-27
- 2021-04-03
- 2021-04-10
-
2021-04-14
Dose 2 — Moderna
-
2021-04-14
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-15
Survey response — days 1–6 daily, dose 2MedDRA: Chest discomfort, Joint stiffness, Muscle tightness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Tightness in jaw and chestMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-16
-
2021-04-17
Health check-in — days 1–6 daily, dose 2Feeling: Good · Headache, Fatigue or tirednessAdult check-in
- 2021-04-19
- 2021-04-20
- 2021-04-21
- 2021-04-28
- 2021-05-05
- 2021-05-12
- 2021-05-19
- 2021-05-26
- 2021-07-14
- 2021-10-13
-
2021-11-23
Dose 3 — Moderna
- 2022-04-18
-
2022-10-03
Dose 4 — Moderna
-
2022-10-04
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-10-05
- 2022-10-06
- 2022-10-07
- 2022-10-08
- 2022-10-09
-
2022-10-10
Survey response — day 7, dose 4MedDRA: Axillary mass, Tenderness — Feeling: GoodFree text: Previously had a lump under Left arm, sore to touch, better 48 hours post-vaccineMedDRA releases: 2024-11 · check-in free text available
- 2022-10-17
- 2022-10-24
- 2022-10-31
- 2022-11-07
- 2022-11-14
- 2023-01-02
-
2023-04-03
Survey response — 6 months, dose 4MedDRA: Dyspnoea, Pregnancy — Feeling: GoodMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-13 | Moderna | |
| 2 | 2021-04-14 | Moderna | |
| 3 | 2021-11-23 | Moderna | No |
| 4 | 2022-10-03 | Moderna | No |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Night sweats overnight
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Tightness in jaw and chest
Release 12 — day 7, dose 4
Systemic reaction (other): Previously had a lump under Left arm, sore to touch, better 48 hours post-vaccine
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 | Dyspnoea | · | · | ✓ |
| SD | Pregnancy | · | · | ✓ |
| SRO | Axillary mass | · | · | ✓ |
| SRO | Chest discomfort | ✓ | ✓ | ✓ |
| SRO | Joint stiffness | ✓ | ✓ | ○ |
| SRO | Muscle tightness | · | · | ✓ |
| SRO | Night sweats | ✓ | ✓ | ✓ |
| SRO | Tenderness | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release