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2AB-29551-00121

2 vaccinations 5 coded responses 18 check-ins 5 free-text entries 1 call case
Sex
—
Age at first dose
66+
ZIP prefix
342 / FL
Registered
2021-01-12
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-07
    Dose 1 — Moderna
  2. 2021-01-12
    Registered in v-safe
  3. 2021-01-12
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pain, Unevaluable event — Feeling: Good · Site: Pain
    Free text: Note. Almost no pain after 24 hpurs and none after 48 hours.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-01-14
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  5. 2021-01-21
    Survey response — day 14, dose 1
    MedDRA: Fatigue, Pain — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Achy, tired
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-01-28
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  7. 2021-02-02
    Dose 2 — Moderna
  8. 2021-02-04
    Survey response — days 1–6 daily, dose 2
    MedDRA: Chills — Feeling: Fair · Site: Pain, Swelling · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Theae were yesterday. Mostly gone today. No chills today.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-02-05
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Redness · None
    Adult check-in
  10. 2021-02-06
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Redness · None
    Adult check-in
  11. 2021-02-07
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  12. 2021-02-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  13. 2021-02-11
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  14. 2021-02-16
    Survey response — day 14, dose 2
    MedDRA: Rash, Rash pruritic — Feeling: Fair
    Free text: I realized a few days ago rhat a very itchy rash on my kegs,which started later than 2-9 could be a reaction to tbe vaccine. At first i though it was bug bites,bit as it spread and got worse it occurred to me that i should have reported it earlier.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-02-23
    Survey response — day 21, dose 2
    MedDRA: Office visit, Rash, Rash pruritic — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional
    Free text: Symptoms: Huge itchy rash over both kegs and injection arm. Dermatologist says it us a reaction to the vaccine. Staeted abouf 3 or 4 days after shot #2. · Healthcare visit (other): Exam in Dr.'s office
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-02-23
    Report sent to call center — day 21, dose 2
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  17. 2021-03-02
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  18. 2021-03-09
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-03-16
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-05-04
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-08-05
    Health check-in — 6 months, dose 2
    Feeling: Fair
    Adult check-in
  22. 2021-09-27
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  23. 2022-02-02
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-07Moderna
22021-02-02Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-12

Systemic reaction (other): Note. Almost no pain after 24 hpurs and none after 48 hours.

Release 2 — day 14, dose 1

2021-01-21

Symptoms: Achy, tired

Release 3 — days 1–6 daily, dose 2

2021-02-04

Systemic reaction (other): Theae were yesterday. Mostly gone today. No chills today.

Release 4 — day 14, dose 2

2021-02-16

Symptoms: I realized a few days ago rhat a very itchy rash on my kegs,which started later than 2-9 could be a reaction to tbe vaccine. At first i though it was bug bites,bit as it spread and got worse it occurred to me that i should have reported it earlier. cut off by CDC

Release 4 — day 21, dose 2

2021-02-23

Symptoms: Huge itchy rash over both kegs and injection arm. Dermatologist says it us a reaction to the vaccine. Staeted abouf 3 or 4 days after shot #2.
Healthcare visit (other): Exam in Dr.'s office

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
HCVOOffice visit ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDPain ✓ ✓ ✓
SDRash ✓ ✓ ✓
SDRash pruritic ✓ ✓ ✓
SROChills ✓ ✓ ✓
SROPain ✓ · ✓
SROUnevaluable event ○ ✓ ○

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