28W-67101-27912
4 vaccinations
7 coded responses
32 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 458 / OH
- Registered
- 2021-03-04
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-04
Registered in v-safe
-
2021-03-04
Dose 1 — Moderna
- 2021-03-04
- 2021-03-05
-
2021-03-06
Survey response — days 1–6 daily, dose 1MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Rash on exposure to cardboard and packing tape both yesterday and todayMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-07
- 2021-03-09
-
2021-03-10
Survey response — days 1–6 daily, dose 1MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection siteFree text: Some increased skin rash to adhesivesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-11
- 2021-03-18
- 2021-03-25
-
2021-04-01
Dose 2 — Moderna
- 2021-04-01
-
2021-04-02
Survey response — days 1–6 daily, dose 2MedDRA: Injection site erythema, Tenderness — Feeling: Good · Site: PainFree text: Not a rash but a couple of small red circular marks about an inch below the injection site. They are tender to the touch.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-03
Survey response — days 1–6 daily, dose 2MedDRA: Back pain — Feeling: Good · Site: Pain, Redness, Swelling · Muscle or body achesFree text: Backache starting 36 hrs post injection. Lasted about 6-8 hrs overnightMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-04
Survey response — days 1–6 daily, dose 2MedDRA: Dermatitis contact, Rash erythematous, Rash pruritic — Feeling: Good · Site: Redness, Swelling · Rash, not including the immediate area around the injection siteFree text: Adhesive (bandaids or medical tape) causes itching red rash during first week or f vaccine both first and 2nd oneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-15
-
2021-04-22
Survey response — day 21, dose 2MedDRA: Dizziness, Eye pain, Ocular discomfort, Office visit, Visual impairment — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Strange pain around and in left eye (I am legally blind in this eye). Vision problems in my right eye (my good one). Eye pressure up to 24. Pressure returned to normal 3-4 days later without explanation. Doctors found nothing abnormal · Healthcare visit (other): Ophthalmologist and retina specialistMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-04-22
Report sent to call center — day 21, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-04-29
- 2021-05-06
- 2021-05-13
- 2021-07-01
- 2021-09-30
-
2021-11-13
Dose 3 — Moderna
-
2022-03-02
Call successfulDoes not wish to fill out VAERS report
- 2022-04-01
-
2022-09-30
Dose 4 — Pfizer-BioNTech
-
2022-10-11
Survey response — day 7, dose 4MedDRA: Injection site discomfort — Feeling: GoodFree text: Minor discomfort at injection siteMedDRA releases: 2024-11 · check-in free text available
- 2022-10-14
- 2022-10-21
- 2022-10-28
- 2022-11-04
- 2022-11-11
- 2022-12-30
- 2023-03-31
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-04 | Moderna | |
| 2 | 2021-04-01 | Moderna | |
| 3 | 2021-11-13 | Moderna | No |
| 4 | 2022-09-30 | Pfizer-BioNTech | No |
Call center
1 call center case
1 successful
Free text
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Rash on exposure to cardboard and packing tape both yesterday and today
Systemic reaction (other): Some increased skin rash to adhesives
Release 6 — days 1–6 daily, dose 2
Systemic reaction (other): Not a rash but a couple of small red circular marks about an inch below the injection site. They are tender to the touch.
Systemic reaction (other): Backache starting 36 hrs post injection. Lasted about 6-8 hrs overnight
Systemic reaction (other): Adhesive (bandaids or medical tape) causes itching red rash during first week or f vaccine both first and 2nd one
Release 7 — day 21, dose 2
Symptoms: Strange pain around and in left eye (I am legally blind in this eye). Vision problems in my right eye (my good one). Eye pressure up to 24. Pressure returned to normal 3-4 days later without explanation. Doctors found nothing abnormal
Healthcare visit (other): Ophthalmologist and retina specialist
Release 12 — day 7, dose 4
Systemic reaction (other): Minor discomfort at injection site
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 |
|---|---|---|---|---|
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Eye pain | ✓ | ✓ | ✓ |
| SD | Ocular discomfort | ✓ | ✓ | ✓ |
| SD | Visual impairment | ✓ | ✓ | ✓ |
| SRO | Back pain | ✓ | ✓ | ✓ |
| SRO | Dermatitis contact | ✓ | ✓ | ✓ |
| SRO | Injection site discomfort | · | · | ✓ |
| SRO | Injection site erythema | ✓ | ✓ | ✓ |
| SRO | Rash | ✓ | ✓ | ✓ |
| SRO | Rash erythematous | ✓ | ✓ | ✓ |
| SRO | Rash pruritic | ✓ | ✓ | ✓ |
| SRO | Tenderness | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release