Z95-69331-79493
2 vaccinations
6 coded responses
15 check-ins
6 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 187 / PA
- Registered
- 2021-03-29
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-04
Dose 1 — Moderna
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2021-03-29
Registered in v-safe
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2021-03-29
Survey response — day 21, dose 1MedDRA: Blood glucose increased, Headache — Feeling: GoodFree text: Sugar is higher than normal for the past 3 weeks. Slight head ache that I never get since my 20's.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-01
Dose 2 — Moderna
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2021-04-01
Survey response — day 0, dose 2MedDRA: Peripheral swelling — Feeling: Good · Muscle or body achesFree text: after my first shot my arm swelled at the top the size of a grapefruitMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-02
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Nausea · Be unable to do your normal daily activitiesAdult check-in
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2021-04-03
Survey response — days 1–6 daily, dose 2MedDRA: Feeling abnormal — Feeling: GoodFree text: Last night ran a fever of 100 didn't feel good took an aspirin woke up this morning feeling goodMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-15
- 2021-04-22
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2021-04-29
Survey response — day 28, dose 2MedDRA: Electric shock sensation — Feeling: GoodFree text: Little shocks in my head like fireworks going off rather than a headacheMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-06
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2021-05-13
Survey response — day 42, dose 2MedDRA: Constipation, Intestinal haemorrhage, Pyrexia — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Became constipated which caused severe intestinal bleeding. Had to wear a diaper type pad for four days fever 101.6 it took four days but fever down to 99.2MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-07-02
Survey response — 3 months, dose 2MedDRA: Post procedural infection, Postoperative adhesion — Feeling: Good · Be unable to do your normal daily activitiesFree text: Adhesions from old surgery popped intentional vein caused an infection.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-04 | Moderna | |
| 2 | 2021-04-01 | Moderna |
Free text
Release 6 — day 21, dose 1
Symptoms: Sugar is higher than normal for the past 3 weeks. Slight head ache that I never get since my 20's.
Release 6 — day 0, dose 2
Systemic reaction (other): after my first shot my arm swelled at the top the size of a grapefruit
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Last night ran a fever of 100 didn't feel good took an aspirin woke up this morning feeling good
Release 8 — day 28, dose 2
Symptoms: Little shocks in my head like fireworks going off rather than a headache
Release 8 — day 42, dose 2
Symptoms: Became constipated which caused severe intestinal bleeding. Had to wear a diaper type pad for four days fever 101.6 it took four days but fever down to 99.2
Release 9 — 3 months, dose 2
Symptoms: Adhesions from old surgery popped intentional vein caused an infection.
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 | Blood glucose increased | ✓ | ✓ | ✓ |
| SD | Constipation | ✓ | ✓ | ✓ |
| SD | Electric shock sensation | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Intestinal haemorrhage | ✓ | ✓ | ✓ |
| SD | Post procedural infection | ✓ | ✓ | ✓ |
| SD | Postoperative adhesion | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Peripheral swelling | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release