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
-
2021-01-07
Dose 1 — Moderna
-
2021-01-12
Registered in v-safe
-
2021-01-12
Survey response — days 1–6 daily, dose 1MedDRA: Pain, Unevaluable event — Feeling: Good · Site: PainFree 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
- 2021-01-14
-
2021-01-21
Survey response — day 14, dose 1MedDRA: Fatigue, Pain — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Achy, tiredMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-28
-
2021-02-02
Dose 2 — Moderna
-
2021-02-04
Survey response — days 1–6 daily, dose 2MedDRA: Chills — Feeling: Fair · Site: Pain, Swelling · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Theae were yesterday. Mostly gone today. No chills today.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-05
- 2021-02-06
- 2021-02-07
- 2021-02-08
- 2021-02-11
-
2021-02-16
Survey response — day 14, dose 2MedDRA: Rash, Rash pruritic — Feeling: FairFree 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
-
2021-02-23
Survey response — day 21, dose 2MedDRA: Office visit, Rash, Rash pruritic — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree 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 officeMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-23
Report sent to call center — day 21, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-02
- 2021-03-09
- 2021-03-16
- 2021-05-04
- 2021-08-05
-
2021-09-27
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2022-02-02
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-07 | Moderna | |
| 2 | 2021-02-02 | Moderna |
Call center
1 call center case
1 successful
Free text
Release 1 — days 1–6 daily, dose 1
Systemic reaction (other): Note. Almost no pain after 24 hpurs and none after 48 hours.
Release 2 — day 14, dose 1
Symptoms: Achy, tired
Release 3 — days 1–6 daily, dose 2
Systemic reaction (other): Theae were yesterday. Mostly gone today. No chills today.
Release 4 — day 14, dose 2
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
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
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Office visit | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Rash | ✓ | ✓ | ✓ |
| SD | Rash pruritic | ✓ | ✓ | ✓ |
| SRO | Chills | ✓ | ✓ | ✓ |
| SRO | Pain | ✓ | · | ✓ |
| SRO | Unevaluable event | ○ | ✓ | ○ |
✓ active code · ○ coded but marked inactive · blank = not in that release