ZLA-25397-83354
3 vaccinations
4 coded responses
13 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 41-45
- ZIP prefix
- 970 / OR
- Registered
- 2021-02-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
KTG-21721-20222
Child or adolescent in my care · Male · 2021-12-04
NFJ-12950-69699
Child or adolescent in my care · Female · 2021-12-04
Timeline
-
2021-01-20
Dose 1 — Moderna
-
2021-02-03
Registered in v-safe
-
2021-02-03
Survey response — day 14, dose 1MedDRA: Fatigue, Feeling abnormal, Injection site rash, Lymphadenopathy — Feeling: GoodFree text: 1/27/21: swollen lymph node on left neck, quarter-size, above the collarbone. Still there, no change in size. 1/28/21: rash on left arm, where the vaccine was administered, approximately 1.5 W x 3 H, lasted for approx. 3 days. More tired/foggyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-10
-
2021-02-17
Dose 2 — Moderna
-
2021-02-24
Survey response — day 7, dose 2MedDRA: Dizziness — Feeling: Fair · Site: Itching · Headache, Fatigue or tirednessFree text: DizzinessMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-03
- 2021-03-10
- 2021-03-17
- 2021-03-24
- 2021-03-31
- 2021-05-19
- 2021-08-18
-
2021-11-08
Dose 3 — Pfizer-BioNTech
-
2021-12-04
Survey response — day 21, dose 3MedDRA: Lymphadenopathy, Somnolence — Feeling: GoodFree text: The day after the 3rd dose, I felt groggy and the lymph node under my left armpit (same side as the shot) was extremely swollen for 4 days.MedDRA releases: 2024-11 · check-in free text available
- 2022-02-07
-
2022-05-09
Survey response — 6 months, dose 3MedDRA: Nasal congestion, SARS-CoV-2 test positive — Feeling: Good · Be unable to work or attend schoolFree text: I rested positive for Covid on 4/28/22. I am still getting over a stuffy nose, but 98%.MedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-20 | Moderna | |
| 2 | 2021-02-17 | Moderna | |
| 3 | 2021-11-08 | Pfizer-BioNTech | No |
Free text
Release 3 — day 14, dose 1
Symptoms: 1/27/21: swollen lymph node on left neck, quarter-size, above the collarbone. Still there, no change in size. 1/28/21: rash on left arm, where the vaccine was administered, approximately 1.5 W x 3 H, lasted for approx. 3 days. More tired/foggy
Release 4 — day 7, dose 2
Systemic reaction (other): Dizziness
Release 10 — day 21, dose 3
Symptoms: The day after the 3rd dose, I felt groggy and the lymph node under my left armpit (same side as the shot) was extremely swollen for 4 days.
Release 11 — 6 months, dose 3
Symptoms: I rested positive for Covid on 4/28/22. I am still getting over a stuffy nose, but 98%.
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 | Fatigue | ✓ | ✓ | ✓ |
| SD | Feeling abnormal | ✓ | ✓ | ✓ |
| SD | Injection site rash | ✓ | ✓ | ✓ |
| SD | Lymphadenopathy | ✓ | ✓ | ✓ |
| SD | Nasal congestion | · | · | ✓ |
| SD | SARS-CoV-2 test positive | · | · | ✓ |
| SD | Somnolence | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release