2LP-27007-87880
2 vaccinations
3 coded responses
24 check-ins
3 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 316 / GA
- Registered
- 2021-08-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-08-17
Dose 1 — Moderna
-
2021-08-19
Registered in v-safe
-
2021-08-19
Survey response — days 1–6 daily, dose 1MedDRA: Pruritus, Rash, Rash erythematous — Feeling: Good · Site: PainFree text: Red rash on the arm that I got the injection, and feeling itchy all over, although mild.MedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-08-20
- 2021-08-21
- 2021-08-22
- 2021-08-23
-
2021-08-24
Survey response — day 7, dose 1MedDRA: Injection site bruising, Injection site discolouration, Injection site rash, Rash macular, Skin discolouration — Feeling: GoodFree text: After the vaccine, I had bruising for about 8 inches below the shot spot. First it was a really red splotch that turned dark blue and spread out and down nearly to my elbow. Its currently various shades of yellow.MedDRA releases: 2021-09,2024-11 · check-in free text available
- 2021-08-31
- 2021-09-07
- 2021-09-14
-
2021-09-20
Dose 2 — Moderna
- 2021-09-20
- 2021-09-21
- 2021-09-22
- 2021-09-23
- 2021-09-24
- 2021-09-25
- 2021-09-26
- 2021-09-27
- 2021-10-04
-
2021-10-11
Survey response — day 21, dose 2MedDRA: Nasopharyngitis, Office visit, Viral infection — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Symptoms: I've just developed a really bad cold over the weekend. I don't think it has anything to do with the vaccine. I went to the dr today and he said it's just viral. I'm feeling better than I did yesterday. · Healthcare visit (other): A regular drs visit at (b)(6) Family Medicine.MedDRA releases: 2024-11 · check-in free text available
-
2021-10-11
Report sent to call center — day 21, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2021-10-18
-
2021-10-18
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
- 2021-10-25
- 2021-11-01
- 2021-12-20
- 2022-03-21
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-08-17 | Moderna | No |
| 2 | 2021-09-20 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 9 — days 1–6 daily, dose 1
Systemic reaction (other): Red rash on the arm that I got the injection, and feeling itchy all over, although mild.
Release 9 — day 7, dose 1
Systemic reaction (other): After the vaccine, I had bruising for about 8 inches below the shot spot. First it was a really red splotch that turned dark blue and spread out and down nearly to my elbow. Its currently various shades of yellow.
Release 10 — day 21, dose 2
Symptoms: I've just developed a really bad cold over the weekend. I don't think it has anything to do with the vaccine. I went to the dr today and he said it's just viral. I'm feeling better than I did yesterday.
Healthcare visit (other): A regular drs visit at (b)(6) Family Medicine.
redacted (b)(6)
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 | Nasopharyngitis | · | · | ✓ |
| SD | Office visit | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
| SRO | Injection site bruising | ✓ | · | ✓ |
| SRO | Injection site discolouration | ✓ | · | ✓ |
| SRO | Injection site rash | ✓ | · | ✓ |
| SRO | Pruritus | ✓ | · | ✓ |
| SRO | Rash | ✓ | · | ✓ |
| SRO | Rash erythematous | ✓ | · | ✓ |
| SRO | Rash macular | ✓ | · | ✓ |
| SRO | Skin discolouration | ✓ | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release