ZLF-13941-46352
4 vaccinations
3 coded responses
20 check-ins
3 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 31-35
- ZIP prefix
- 801 / CO
- Registered
- 2021-11-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
PEN-18128-29710
Child or adolescent in my care · Male · 2022-06-27
2N7-13822-43600
Child or adolescent in my care · Female · 2022-11-16
Timeline
-
2021-03-02
Dose 1 — Moderna
-
2021-03-30
Dose 2 — Moderna
-
2021-11-10
Dose 3 — Moderna
-
2021-11-16
Registered in v-safe
-
2021-11-16
Survey response — days 1–6 daily, dose 3MedDRA: Pregnancy — Feeling: GoodFree text: 20 weeks pregnant at time of boosterMedDRA releases: 2024-11 · check-in free text available
- 2021-11-17
-
2021-11-24
Survey response — day 14, dose 3MedDRA: Chills, Headache — Feeling: Good · Be unable to do your normal daily activitiesFree text: Headache and some chills occured over the course of about two days last week.MedDRA releases: 2024-11 · check-in free text available
- 2021-12-01
- 2021-12-08
-
2021-12-22
Survey response — day 42, dose 3MedDRA: Fatigue, Headache, Nasopharyngitis, Sinus pain — Feeling: Poor · Be unable to do your normal daily activitiesFree text: Symptoms of head cold, sinus pain, headache, fatigueMedDRA releases: 2024-11 · check-in free text available
- 2022-02-09
-
2022-09-26
Dose 4 — Pfizer-BioNTechCo-administered: Flu
-
2022-09-27
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Itching · Headache, Muscle or body aches, NauseaAdult check-in
-
2022-09-28
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Itching · HeadacheAdult check-in
- 2022-09-29
- 2022-09-30
- 2022-10-01
- 2022-10-02
- 2022-10-03
- 2022-10-10
- 2022-10-17
- 2022-10-25
- 2022-10-31
- 2022-11-07
- 2022-12-26
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-02 | Moderna | No |
| 2 | 2021-03-30 | Moderna | No |
| 3 | 2021-11-10 | Moderna | No |
| 4 | 2022-09-26 | Pfizer-BioNTech | Flu |
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): 20 weeks pregnant at time of booster
Release 10 — day 14, dose 3
Symptoms: Headache and some chills occured over the course of about two days last week.
Release 10 — day 42, dose 3
Symptoms: Symptoms of head cold, sinus pain, headache, fatigue
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 | Chills | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Sinus pain | · | · | ✓ |
| SRO | Pregnancy | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release