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2XV-27437-00786

3 vaccinations 2 coded responses 26 check-ins 2 free-text entries 1 call case
Sex
Female
Age at first dose
66+
ZIP prefix
300 / GA
Registered
2021-01-12
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-11
    Dose 1 — Moderna
  2. 2021-01-12
    Registered in v-safe
  3. 2021-01-12
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Abdominal pain
    Adult check-in
  4. 2021-01-13
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Swelling · None
    Adult check-in
  5. 2021-01-14
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-01-15
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-01-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Nausea
    Adult check-in
  8. 2021-01-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-01-18
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-01-25
    Survey response — day 14, dose 1
    MedDRA: Erythema, Immediate post-injection reaction, Injection site pruritus, Swelling — Feeling: Good
    Free text: On day 10 post vaccination I developed swelling redness and itching at vaccination site.I visited my primary care physician today this condition has continued.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-02-01
    Survey response — day 21, dose 1
    MedDRA: Injection site erythema, Injection site pruritus, Injection site rash, Injection site swelling, Office visit, Self-medication — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: I have developed the COVID rash at the injection site. It has lasted for 10 days. Itchy, red, swollen. It is improving as of day 20z I went to my healthcare provider snd I am taking benedryl for relief of the symptoms. I am concerned about my second · Healthcare visit (other): Office vidit
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-02-01
    Report sent to call center — day 21, dose 1
    Get care from a doctor or other healthcare professional
    1 call case(s)
  13. 2021-02-08
    Health check-in — day 28, dose 1
    Feeling: Good
    Adult check-in
  14. 2021-02-10
    Dose 2 — Moderna
  15. 2021-02-11
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain, Swelling · Headache, Nausea · Be unable to do your normal daily activities
    Adult check-in
  16. 2021-02-12
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Itching · None
    Adult check-in
  17. 2021-02-13
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Redness, Swelling, Itching · None
    Adult check-in
  18. 2021-02-14
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain, Redness, Swelling, Itching · None
    Adult check-in
  19. 2021-02-15
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness, Swelling, Itching · None
    Adult check-in
  20. 2021-02-16
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Redness, Itching · None
    Adult check-in
  21. 2021-02-17
    Health check-in — day 7, dose 2
    Feeling: Good · Site: Redness, Swelling · None
    Adult check-in
  22. 2021-06-14
  23. 2021-08-11
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-10-25
    Dose 3 — Moderna
  25. 2021-10-27
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · Headache
    Adult check-in
  26. 2021-10-28
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · Headache
    Adult check-in
  27. 2021-10-29
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  28. 2021-10-30
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  29. 2021-10-31
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  30. 2021-11-01
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  31. 2021-11-08
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  32. 2021-11-15
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-01-11Moderna
22021-02-10Moderna
32021-10-25Moderna No

Call center

1 call center case

1 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 2 — day 14, dose 1

2021-01-25

Symptoms: On day 10 post vaccination I developed swelling redness and itching at vaccination site.I visited my primary care physician today this condition has continued.

Release 3 — day 21, dose 1

2021-02-01

Symptoms: I have developed the COVID rash at the injection site. It has lasted for 10 days. Itchy, red, swollen. It is improving as of day 20z I went to my healthcare provider snd I am taking benedryl for relief of the symptoms. I am concerned about my second cut off by CDC
Healthcare visit (other): Office vidit

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 ✓ ✓ ✓
SDErythema ✓ ✓ ✓
SDImmediate post-injection reaction ✓ ✓ ✓
SDInjection site erythema ✓ ✓ ✓
SDInjection site pruritus ✓ ✓ ✓
SDInjection site rash ✓ ✓ ✓
SDInjection site swelling ✓ ✓ ✓
SDSelf-medication ✓ ✓ ✓
SDSwelling ✓ ✓ ✓

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

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