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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

  1. 2021-03-04
    Dose 1 — Moderna
  2. 2021-03-29
    Registered in v-safe
  3. 2021-03-29
    Survey response — day 21, dose 1
    MedDRA: Blood glucose increased, Headache — Feeling: Good
    Free 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
  4. 2021-04-01
    Dose 2 — Moderna
  5. 2021-04-01
    Survey response — day 0, dose 2
    MedDRA: Peripheral swelling — Feeling: Good · Muscle or body aches
    Free text: after my first shot my arm swelled at the top the size of a grapefruit
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-04-02
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Nausea · Be unable to do your normal daily activities
    Adult check-in
  7. 2021-04-03
    Survey response — days 1–6 daily, dose 2
    MedDRA: Feeling abnormal — Feeling: Good
    Free text: Last night ran a fever of 100 didn't feel good took an aspirin woke up this morning feeling good
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-04-04
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  9. 2021-04-05
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  10. 2021-04-06
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  11. 2021-04-07
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  12. 2021-04-08
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  13. 2021-04-15
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  14. 2021-04-22
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  15. 2021-04-29
    Survey response — day 28, dose 2
    MedDRA: Electric shock sensation — Feeling: Good
    Free text: Little shocks in my head like fireworks going off rather than a headache
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-05-06
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  17. 2021-05-13
    Survey response — day 42, dose 2
    MedDRA: Constipation, Intestinal haemorrhage, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities
    Free 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 99.2
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-07-02
    Survey response — 3 months, dose 2
    MedDRA: Post procedural infection, Postoperative adhesion — Feeling: Good · Be unable to do your normal daily activities
    Free 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

DoseDateManufacturerCo-administered
12021-03-04Moderna
22021-04-01Moderna

Free text

Release 6 — day 21, dose 1

2021-03-29

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

2021-04-01

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

2021-04-03

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

2021-04-29

Symptoms: Little shocks in my head like fireworks going off rather than a headache

Release 8 — day 42, dose 2

2021-05-13

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

2021-07-02

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

FieldPreferred term2021-092023-042024-11
SDBlood glucose increased ✓ ✓ ✓
SDConstipation ✓ ✓ ✓
SDElectric shock sensation ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDIntestinal haemorrhage ✓ ✓ ✓
SDPost procedural infection ✓ ✓ ✓
SDPostoperative adhesion ✓ ✓ ✓
SDPyrexia ✓ ✓ ✓
SROFeeling abnormal ✓ ✓ ✓
SROPeripheral swelling ✓ ✓ ✓

✓ active code · ○ coded but marked inactive · blank = not in that release