Z9B-73400-61373
2 vaccinations
4 coded responses
25 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 496 / MI
- Registered
- 2021-03-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-12
Dose 1 — Moderna
-
2021-03-13
Registered in v-safe
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
-
2021-03-18
Survey response — days 1–6 daily, dose 1MedDRA: Sinus disorder — Feeling: GoodFree text: Just my sinuses which isnt new. I just have to keep working on them every day, thats all. As far as the vaccine, no problem.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-19
- 2021-03-26
- 2021-04-02
-
2021-04-09
Dose 2 — Moderna
- 2021-04-09
- 2021-04-10
-
2021-04-11
Survey response — days 1–6 daily, dose 2MedDRA: Condition aggravated, Dry mouth, Pre-existing disease — Feeling: GoodFree text: More dry mouth than I usually do. I have a condition and meds both that cause it. But it is much worse.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-12
- 2021-04-13
- 2021-04-14
- 2021-04-15
- 2021-04-16
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-05-14
- 2021-05-21
- 2021-07-09
-
2021-10-11
Survey response — 6 months, dose 2MedDRA: Arthralgia, Fatigue, Headache, Office visit — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Not so much new but more intense. Joint pain and pain in more of my joints. Fatigue headaches.. my Doctor has sent blood work to Mayo to have it checked.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-09
Survey response — 12 months, dose 2MedDRA: Knee arthroplasty — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Knee replacement surgery, March 28, 2022MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-12 | Moderna | |
| 2 | 2021-04-09 | Moderna |
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Just my sinuses which isnt new. I just have to keep working on them every day, thats all. As far as the vaccine, no problem.
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): More dry mouth than I usually do. I have a condition and meds both that cause it. But it is much worse.
Release 10 — 6 months, dose 2
Symptoms: Not so much new but more intense. Joint pain and pain in more of my joints. Fatigue headaches.. my Doctor has sent blood work to Mayo to have it checked.
Release 11 — 12 months, dose 2
Symptoms: Knee replacement surgery, March 28, 2022
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 | Arthralgia | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Knee arthroplasty | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SRO | Condition aggravated | ✓ | ✓ | ✓ |
| SRO | Dry mouth | ✓ | ✓ | ✓ |
| SRO | Pre-existing disease | ✓ | ✓ | ✓ |
| SRO | Sinus disorder | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release